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Dissomnicheskiye rasstroystva (DR) pri yuvenil'nom revmatoidnom artrite (YURA) — odno iz naiboleye rasprostranennykh, tyazhelo perenosimykh i dezadaptiruyushchikh sostoyaniy. Tsel' issledovaniya — otsenit' rasprostranennost' i strukturu DR, ikh vzaimosvyaz' s klinicheskimi osobennostyami, vklad v snizheniye kachestva zhizni u bol'nykh YURA. Na I etape otsenivali rasprostranennost' DR v sploshnoy vyborke bol'nykh YURA i zdorovykh detey 8–16 let. Na II etape u bol'nykh YURA s verifitsirovannymi DR otsenivali ikh strukturu, genderno-vozrastnyye osobennosti, vzaimosvyaz' s osnovnymi klinicheskimi kharakteristikami YURA, kachestvom zhizni bol'nykh. Primenyali shkalu dlya otsenki kachestva sna SDSC, oprosnik kachestva zhizni — PedsQL 4.0, indeks Richi. U bol'nykh YURA DR vstrechayutsya v 3,3 raza chashche, chem u zdorovykh detey (u 178 (72,3%) i u 93 (22,2%) sootvetstvenno). Spektr DR byl predstavlen rasstroystvami initsiatsii i podderzhaniya sna — 54 (22,0%), rasstroystvami dykhaniya — 32 (13,0%), rasstroystvami perekhoda sna v bodrstvovaniye — 31 (12,6%), rasstroystvami chrezmernoy sonlivosti — 38 (15,4%) i ikh sochetaniyami — 23 (9,3%). U devochek bol'she vyrazheny rasstroystva initsiatsii i podderzhaniya sna (r = 0,003), u mal'chikov — rasstroystva chrezmernoy sonlivosti (r = 0,008). Tyazhest' DR narastayet po mere uvelicheniya vozrasta bol'nykh (r = 0,69; p = 0,001) i vozrasta debyuta YURA (r = 0,71; p = 0,001), pri poliartikulyarnom variante (r = 0,32; p = 0,048). Utochnena svyaz' DR s pokazatelyami vospalitel'nogo (r = 0,56; p = 0,001), sustavnogo indeksov (r = 0,44; p = 0,005) i prodolzhitel'nost'yu utrenney skovannosti (r = 0,49; p = 0,029). Nalichiye vzaimosvyazi DR i YURA diktuyet neobkhodimost' provedeniya rutinnoy diagnostiki DR u dannoy kategorii bol'nykh, pri etom dlya vedeniya DR neobkhodimo primenyat' skoreye personifitsirovannyy lechebno-diagnosticheskiy podkhod, chem rastsenivat' yego v kachestve odnogo iz sindromov YURA.

Dissomnicheskiye rasstroystva pri yuvenil'nom revmatoidnom artrite: vliyaniye na kachestvo zhizni