IV期肺癌患者不同的远处转移与睡眠质量的 相关性研究

Correlation between Sleep Quality and Different Distant Metastases in Patients with Stage IV Lung Cancer

摘要: 目的：探索IV期肺癌患者睡眠质量与不同的远处转移临床特征的相关性。方法：选取2024年6月到12月在安徽医科大学第二附属医院治疗的386例肺癌患者。匹兹堡睡眠质量指数(PSQI)被用来评估不同转移患者的睡眠质量。采用二元Logistic回归校正后的比值比(aOR)来比较不同的远处转移发生睡眠障碍的具体风险差异。结果：68.6%的IV期肺癌患者被归类为睡眠障碍。不同转移的肺癌患者睡眠质量差异明显，其中肝转移患者PSQI评分的中位数为11.0 (8.0, 13.0)，明显高于单个骨转移8.0 (6.0, 9.0)，多发性骨转移的睡眠评分介于两者之间。多因素分析显示，肝转移与睡眠障碍发生明显相关(aOR = 3.62, 95% CI: 2.49~5.26, P < 0.001)；同样，多发骨转移患者患有睡眠障碍的风险升高(aOR = 2.79, 95% CI: 1.53~5.08, P < 0.001)。结论：经历病情进展的晚期肺癌患者睡眠质量明显恶化。存在肝脏或多发性骨转移的肺癌患者，患有睡眠障碍的风险升高。

Abstract: Objective: This study aims to explore the association between different distant metastases and sleep quality in patients with stage IV lung cancer. Methods: A total of 386 lung cancer patients treated at the Second Affiliated Hospital of Anhui Medical University from June to December 2024 were enrolled. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality in patients with different metastatic patterns. Adjusted odds ratio (aOR) derived from binary logistic regression was performed to compare specific risk differences in sleep disturbances among patients with different metastatic profiles. Results: 68.6% of stage IV lung cancer patients were classified as having sleep disturbances. Sleep quality varied significantly according to the metastases. The median PSQI score was 11.0 (8.0, 13.0) in patients with liver metastasis, which was significantly higher than that in patients with single bone metastasis 8.0 (6.0, 9.0), while patients with multiple bone metastases were in intermediate scores. Multivariate analysis showed that liver metastasis was significantly associated with sleep disturbances (aOR = 3.62, 95% CI: 2.49~5.26, P < 0.001). Similarly, patients with multiple bone metastases had an increased risk of sleep disturbances (aOR = 2.79, 95% CI: 1.53~5.08, P < 0.001). Conclusion: The sleep quality of advanced lung cancer patients deteriorates significantly with disease progression. Lung cancer patients with liver metastasis or multiple bone metastases are at an increased risk of sleep disturbances.