轻度认知损害老年人的睡眠障碍及干预效果  

Sleep Disorders in Patients with Mild Cognitive Impairment and the Effect of Melatonin Treatment

作　　者：张宝和[1] 张昭馥[1] 何荆贵[2] 张熙[2] 王鲁宁[2] 

机构地区：[1]海军总医院干三科,北京100037 [2]解放军总医院南楼神经内科,北京100039

出　　处：《海军总医院学报》2006年第2期76-79,共4页Journal of Naval General Hospital of PLA

摘　　要：目的研究轻度认知损害老年人的睡眠障碍,以及褪黑素的干预效果。方法利用简短精神状态检查、词表学习、符号数字测验等,检查轻度认知损害老年人认知功能,通过匹兹堡、爱泼沃斯睡眠量表、多导睡眠图睡眠监测,观察其睡眠障碍情况。比较轻度认知损害老年人服用褪黑素前后,睡眠障碍及认知损害改善情况。结果①轻度认知损害老年人精神状态检查、词语即刻、延迟记忆、2 min词语延迟保持率、数字符号等成绩较差;②轻度认知损害老年人爱泼沃斯、多导睡眠图结果较差,入睡潜伏期及快速眼动睡眠潜伏期延长,其精神状态检查成绩与爱泼沃斯显著相关;③褪黑素治疗后,轻度认知损害老年人睡眠效率增加,精神状态检查、词语即刻及延迟回忆成绩提高。结论①轻度认知损害老年人存在着明显的认知损害及睡眠障碍;②褪黑素可部分改善轻度认知损害老年人睡眠障碍及认知损害。Objective To explore the sleep disorders and cognitive impairment in the elderly with mild cognitive impairment（MCI） and to observe the effect of melatonin treatment. Methods Seventy four MCI and 112 controls were tested by pittsburgh sleep quality index （PSQI）, epworth sleepiness scale （ESS）, mini-mental state examination （MMSE）,word list recall and digital symbol test. Twenty one MCI and 28 controls were tested by polysomnography. Nine MCI and 10 controls were randomized by double blindness into 2 groups using melatonin in the experimental group and the control group. MMSE , PSQI, ESS, word recall, delayed word recall, 2-minute retaining rate, digital symbol test, Sleep efficiency and Sleep incubation period were employed to evaluate the effect of melatonin. Results The MCI subjects showed lower performance in MMSE, word recall,delayed word recall, 2-minute retaining rate, digital symbol test, and higher performarce in ESS,PSQI,latent period of sleep latent of rapid eye movement sleep （P〈0.05）. There was a relationship between ESS and MMSE. Melatonin could effectively improve sleep disorders. After the treatment, some cognitive impairments in MCI were improved significantly . Conclusion Elderly people with MCI show an increase in sleep disorders. Some sleep disorders and cognitive impairment in MCI were improved significantly after the treatment of Melatonin.

关 键 词：轻度认知损害 睡眠障碍 褪黑素 老年人 

分 类 号：R749.16[医药卫生—神经病学与精神病学]