维持性血液透析患者睡眠障碍与炎症介质及生命质量的中介效应

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Mediating Effects of Inflammatory Factors on Sleep Disturbances and Quality ofLifeinPatientsUndergoingMaintenanceHemodialysis

ZHENG Quanlin，ZHENG Zili，WANG Yanqiao （Department of Nephrology，Jinjiang Hospital，Jinjiang 36220o，China）

AbstractObjective：Toexploretherelationshipsamong sleepdisturbances，inflammatoryfactorlevels，andqualityof ife inpatientsundergongmaintenancehemodialysis（MHD），andtoanalyzethemediatingefectsofinflammatoryfactorsontheipactof sleepqualityonqualityoflife.Methods：Acro-sectionalstudywasconductedinvolving8OMHDpatientsadmitedtotheHemodialysis Centerof Jinjiang HospitalfromJune2023 to June2O24.Patients weredividedintoasleepdisturbancegroup（51cases， （204号 PSQI⩾8 ） and a non-sleep disturbance group（29 cases， PSQI<8 ）based on Pittsburgh Sleep Quality Index（PSQI） scores. Serum levels of interleukin-6（IL-6） and tumor necrosis factor- α（TNF-α） were measured. Quality of life was assessed using the Kidney Disease QualityofLife-36（KDQOL-36）scale.Diferencesindemographiccharacteristics，inflammatoryfactors，ndqualityoflife betweenthetwo groups werecompared.Correlation analysisand Botstrap mediation analysiswereperformed to explorerelationships among variables. Results：The sleep disturbance group had significantly higher IL-6 and TNF- α levels and lower KDQOL-36 total scores compared with the non-sleep disturbance group （ P<0.001 ）. PSQI scores were positively correlated with IL-6 and TNF- α ，and negatively correlated with KDQOL-36 total scores（ P<0.001） . Mediation analysis showed that IL-6 and TNF- α partially mediated the effect of PSQI on quality of life，with 95% confidence intervals（CI） excluding O. Conclusion： Sleep disturbances arecommonandsevere in MHDpatients.Poorsleepqualitynotonlydirectlyreducesqualityoflifebutalsoindirectlyaffects it by increasing IL-6 and TNF- α levels.

KeywordsMaintenance hemodialysis； Sleepdisturbances； Inflammatory factors;；Interleukin-6；Tumor necrosis factor- αu ; Qual-ity of life；Mediating effects

中图分类号：R459.5；R338.63 文献标识码：A doi：10.3969/j.issn.2095-7130.2025.12.020

维持性血液透析（Maintenance Hemodialysis，MHD）是终末期肾病患者最为主要的长期治疗方式。（剩余5755字）