青年OSAHS患者认知功能与言语识别能力研究  

The Correlation between the Cognitive Function and Speech Recognition Ability in Young OSAHS Patients

作　　者：辛忠海[1,2] 温晓慧[2] 杜晶艳[2] 戴金升 刘锦峰[2] 王宁宇[2] 

机构地区：[1]中国中医科学院望京医院耳鼻喉科,北京100102 [2]首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2017年第1期28-31,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨OSAHS患者认知功能和言语识别能力的关系。方法选择青年男性OSAHS患者60例,年龄18~40岁,根据临床诊断标准及多导睡眠图(polysomnogram,PSG)结果将患者按照呼吸暂停低通气指数(AHI)及低氧血症程度分为:轻度组19例,中度组20例,重度组21例;对照组为正常青年男性(年龄18~40岁)25例。对各组首先进行蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)测试,然后应用普通话言语测听材料(MSTMs)中的15张句表(每表50个关键词)进行言语识别测试。结果 1对照组和轻、中、重度OSAHS患者组MoCA得分总分分别为:28.52±1.16、27.32±1.16、25.85±1.23、24.52±1.69分,四组之间两两比较差异均有统计学意义(P<0.01)。2刺激声强度为22、24、26dB SPL时,重度OSAHS患者的言语识别率(%)分别为:35.4±22.6、56.3±23.9、75.2±16.5,较轻度组(38.4±23.5、58.3±25.5、79.2±18.5)、中度组(38.8±21.6、58.7±22.7、78.5±16.7)、对照组(39.4±23.5、60.3±24.3、80.2±16.4)均降低(P均<0.05)。3各组50%识别率所需的给声强度分别为:轻度组3.66±0.50dB SPL、中度组3.72±0.55dB SPL、重度组4.15±0.80dB SPL、对照组3.62±0.41dB SPL,重度组与其余三组比较差异有统计学意义(P<0.01)。结论 OSAHS患者随着缺氧和病情程度加重,言语识别能力呈下降趋势,这可能是认知评估量表得分降低的重要相关因素。Objective To study the relationship between the cognitive function and speech recognition ability in young patients with OSAHS.Methods We selected 60 young male patients,according to the apnea-hypopnea index（AHI）and the severity of hypoxemia.They were divided into three subgroups on the basis of their syndrome severities：mild group（n=19;AHI 5～15/h,85%≤minimum SaO2≤90%）,moderate group（n=20;AHI〉15～30/h,80%≤minimum SaO2〈 85%）,and severe group（n=21;AHI〉30/h,minimum SaO2〈80%）.First,we used the MoCA scale for cognitive function tests and recorded the scores.Then 15 lists of sentence Mandarin Speech Test Materials（MSTMs）were utilized to test each group.A data analysis was performed using SPSS 17.0software.Results The total MoCA scores（mild group：27.32±1.16;moderate group：25.85±1.23;severe group：24.52±1.69;control group：28.52±1.16）decreased progressively as the disease severity increased,showing significant differences between the control group and the mild,moderate and severe groups of OSAHS patients（all P〈0.05）.When sound stimuli were presented at 22,24,and 26 dB SPL,the speech recognition rates in the patients with severe（35.4±22.6,56.3±23.9,75.2±16.5）lower than the other groups（mild group：38.4±23.5,58.3±25.5,79.2±18.5;moderate group：38.8±21.6,58.7±22.7,78.5±16.7;control group：39.4±23.5,60.3±24.3,80.2±16.4,respectively,all P〈0.05）.The differences in intensity of 50% recognition rate between the severe group（4.15±0.80）and the control（3.62±0.41）,mild（3.66±0.50）and moderate groups（3.72±0.55）of OSAHS patients were statistically significant（all P〈0.05）.Conclusion With hypoxia and disease severity increased,speech recognition abilities in OSAHS patients decreased.This may be an important factor associated with cognitive assessment scale score.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 语句 言语识别测试 认知功能 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]