伴失眠心境恶劣障碍患者记忆功能改变的临床研究  

Clinical research on change of cognitive function in dysthymic patients with insomnia

作　　者：王芳[1] 魏启国 王海棠[1] 陈贵海[2] 

机构地区：[1]安徽医科大学第一附属医院神经内科,合肥230022 [2]南方医科大学附属郴州医院神经内科,湖南省423000

出　　处：《中华脑科疾病与康复杂志（电子版）》2015年第2期5-10,共6页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探索伴有失眠心境恶劣障碍患者的记忆能力改变。方法2013年5—12月在安徽医科大学第一附属医院神经内科睡眠门诊就诊的失眠患者56例，按《诊断与统计手册：精神障碍》第4版（DSM-Ⅳ）诊断标准，将失眠患者分为原发性失眠组（36例）和心境恶劣障碍组（20例），收集患者背景资料，采用九盒迷宫试验检测患者的空间记忆和物体记忆，以健康体检者为对照（25例）。采用SPSS17．0进行统计学分析，组间差异比较采用t检验、单因素方差分析或χ^2检验，并采用偏相关分析确定记忆受损的因素。结果在总体认知功能正常的前提下，与对照组相比，原发性失眠患者的记忆自评分明显降低（Z=6．958，P=0．024），但空间记忆和物体记忆错误分差异不具有统计学意义（P〉0．05）。心境恶劣障碍者的自评分与对照组相比，差异不具有统计学意义（Z=4．312，P=0．164），但空间工作记忆和物体再认记忆错误分明显增高（Z=6．818，P=0．032；Z=7．518，P=0．012）。与原发性失眠者相比，心境恶劣障碍患者记忆自评分（Z=6．712，P=0．030）和物体再认记忆（Z=6．023，P=0．042）的错误分明显增高。此外，患者的记忆自评、空间工作记忆和物体再认记忆受抑郁和睡眠的影响，其中前两者更为显著。结论伴有失眠心境恶劣障碍患者存在空间工作记忆和物体再认记忆受损，且受不同程度抑郁和睡眠的影响。Objective To explore the change of cognitive function in the dythymic patients with insomnia. Methods Patients with insomnia were enrolled from the department of neurology of the First Hospital of Anhni Medical University from May 2013 to December 2013. According to the diagnostic and statistical manual of mental disorders IV （DSM-Ⅳ） , patients were divided into primary insomnia group （36 eases） and dythymic patients with insomnia group （20 cases）. After the patients＇ background information was collected, nine-box maze was used to assess their spatial and object memories. Normal individuals were recruited as the controls（25 cases）. Statistical analysis was performed by using SPSS 17.0. t test,ANOVA or χ^2 test were used to reveal any significant difference between groups, and partial correlation was used to identify the factors of memory impairment. Results Under the condition of normal overall cognitive function, compared to the controls, the primary insomnia patients had significantly lower scores in the self-evaluated memory（Z=6. 958, P = 0. 024）, but there was no statistical difference in the spatial memory and object memory（P 〉0. 05）. In comparison with the controls, the dythymic patients had similar scores in the self- evaluated memory,but more error scores in the spatial working memory and object recognition memory（ Z = 6. 818 ,P = 0. 032 ;Z =7. 518 ,P =0. 012）. Moreover,the dythymic patients showed higher error scores in the self-evaluated memory（ Z = 6. 712, P = 0. 030 ） and object recognition memory （ Z = 6. 023, P = 0. 042 ） than the primary insomnia patients. In addition, the self-evaluated memory, spatial working memory and object recognition memory were correlated with depression and sleep, especially for the former two memories. Condtmion The dythymie patients with insomnia have the impairment of spatial working and object recognition memory, and it may be associated with a certain degree of depression and sleep.

关 键 词：心境恶劣障碍 入睡和睡眠障碍 记忆 九盒迷宫 

分 类 号：R740[医药卫生—神经病学与精神病学]