中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (03): 192-196.doi: 10.3969/j.issn.1671-4091.2026.03.004

• 临床研究 • 上一篇    下一篇

维持性血液透析患者血浆胶质细胞源性神经营养因子与失眠的相关性研究

刘 蕾    王悦至   华 青    袁 琦   

  1. 215000 苏州，1南京医科大学附属苏州医院 苏州市立医院肾内科
  • 收稿日期:2025-06-03 修回日期:2025-12-16 出版日期:2026-03-12 发布日期:2026-03-12
  • 通讯作者: 袁琦 E-mail:yqbeauly@163.com
  • 基金资助:
    国自然青年基金(82300838)； 苏州市姑苏卫生人才计划-人才科研项目(GSWS2022075)； 南京医科大学-齐鲁临床研究基金项目(2024KF0257)

Association of plasma GDNF levels with insomnia in maintenance hemodialysis patients

  1. Department of Nephrology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou 215000, China
  • Received:2025-06-03 Revised:2025-12-16 Online:2026-03-12 Published:2026-03-12
  • Contact: 215000 苏州，1南京医科大学附属苏州医院 苏州市立医院肾内科 E-mail:yqbeauly@163.com

摘要： 目的  探讨维持性血液透析(hemodialysis，HD)患者血浆胶质细胞源性神经营养因子(glial cell line-derived neurotrophic factor，GDNF)水平与失眠间的相关性。 方法  本研究为单中心横断面研究，共纳入无失眠1～3期慢性肾脏病(chronic kidney disease，CKD)患者29例(CKD非失眠组），HD患者103例。根据匹兹堡睡眠质量指数(Pittsburgh sleep quality index，PSQI)将HD患者分为HD非失眠组(PSQI≤5，n=41)，HD轻度失眠组(6≤PSQI≤10，n=37)，HD中重度失眠组(PSQI≥11，n=25)。检测患者血浆GDNF浓度，并评估睡眠状况。 结果  CKD非失眠组与HD非失眠组间血浆GDNF水平存在统计学差异(Z=2.754,P=0.006)。在HD患者中，年龄(F=8.238,P＜0.001)、透析龄(χ2=6.094,P=0.047)及GDNF水平(χ2=8.370,P=0.015)在不同失眠程度组间表现出总体差异。进一步两两比较显示：年龄及GDNF水平在非失眠组与轻度失眠组(t=2.263，P=0.026；Z=2.517，P=0.012)、非失眠组与中重度失眠组之间(t=4.011，P＜0.001；Z=2.360，P=0.018)差异具有统计学意义。Spearman相关分析显示血浆GDNF水平与PSQI总评分呈正相关(ρ=0.290，t=3.045，P=0.003)，并与睡眠质量(ρ=0.334，t=3.561，P＜0.001)、入睡时间(ρ=0.311，t=3.289，P=0.001)、睡眠时间(ρ=0.217，t=2.234，P=0.027)、睡眠效率(ρ=0.241，t=2.496，P=0.014)、睡眠紊乱评分(ρ=0.227，t=2.342，P=0.021)呈正相关。 结论  GDNF水平与HD患者失眠相关，提示GDNF作为血液透析患者失眠的新型生物标志物具有潜在应用价值。

关键词: 胶质细胞源性神经营养因子, 失眠, 血液透析, 匹兹堡睡眠质量指数

Abstract: Objective: To investigate the association between plasma glial cell line-derived neurotrophic factor (GDNF) levels and insomnia in patients undergoing maintenance hemodialysis (HD). Methods: This single-center cross-sectional study enrolled 29 stage 1-3 chronic kidney disease (CKD) patients without insomnia (mean age: 59.93?±?15.03 years) and 103 HD patients (mean age: 59.89?±?11.64 years). Based on Pittsburgh Sleep Quality Index (PSQI) scores, HD patients were categorized into three groups: HD without insomnia (PSQI ≤ 5, n=41), mild insomnia (6 ≤ PSQI ≤ 10, n=37), and moderate to severe insomnia (PSQI ≥ 11, n=25). Plasma GDNF concentrations were measured and sleep quality was assessed using the PSQI. Results: The median GDNF level differed significantly between the non-insomnia CKD group and the non-insomnia HD group (Z=2.754, P=0.006). Among HD patients, age (F=8.238, P=<0.001), dialysis duration (X2=6.094, P=0.047), and GDNF levels (X2 =8.370, P=0.015) showed significant differences across insomnia groups. Pairwise comparisons revealed that both age and GDNF levels were significantly different between the non-insomnia and mild insomnia groups (t=2.263，P=0.026；Z =2.517，P=0.012), as well as between the non-insomnia and moderate-to-severe insomnia groups (t=4.011，P<0.001；Z =2.360，P=0.018). Spearman correlation analysis indicated that plasma GDNF levels were positively correlated with PSQI total score (ρ = 0.290, t=3.045，P=0.003), as well as with components including subjective sleep quality (ρ= 0.334，t=3.561，P<0.001), sleep latency(ρ= 0.311，t=3.289，P=0.001), sleep duration(ρ= 0.217，t=2.234，P=0.027), sleep efficiency(ρ= 0.241，t=2.496，P=0.014), and sleep disturbances (ρ= 0.227，t=2.342，P=0.021). Conclusion: GDNF level was associated with insomnia in HD patients. GDNF may serve as a novel biomarker for insomnia in HD patients.

Key words: Glial cell line-derived neurotrophic factor, Sleep disturbance, Hemodialysis；Pittsburgh sleep quality index

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