OSAHS与脑卒中后患者认知障碍及功能状态的相关性研究  

Relationship between obstructive sleep apnea syndrome and cognitive impairment and functional status after stroke

作　　者：封倩[1] 

机构地区：[1]郑州人民医院神经内科五病区,郑州450012

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第13期1017-1021,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:分析OSAHS与脑卒后患者认知障碍及功能状态的相关性。方法:2014-02-2016-09期间共纳入189例符合研究标准的患者,剔除33例轻度OSAHS患者,86例研究组患者和70例对照组患者纳入最终分析。主要检测指标为认知状态和功能状态。认知状态由以下维度进行评估:警惕性、注意力、记忆力、工作记忆、执行力、语言、洞察力、精神活动、精神运动能力以及智力;利用神经状态和功能独立性评估功能状态。次要指标包括嗜睡、疲劳、焦虑和抑郁及睡眠质量。结果:研究组年龄大于对照组,BMI高于对照组,平均住院时间长于对照组,均差异有统计学意义(均P<0.05)。2组总认知状态差异明显,研究组明显差于对照组(t=9.276,P=0.012)。研究组患者的注意力、执行力、洞察力、心理调节能力和智力均低于对照组,差异有统计学意义(均P<0.05)。研究组较对照组患者的功能状态更差(t=38.094,P=0.000)。2组患者的次要指标包括嗜睡、疲劳、睡眠质量、焦虑和抑郁均差异无统计学意义(均P>0.05)。结论:伴OSAHS的脑卒中患者认知障碍和功能状态明显更差,OSAHS是脑卒中患者预后不良的危险因素。Objective： To analyze the correlation between obstructive sleep apnea syndrome （OSAHS） and cognitive impairment and functional status after stroke. Method：From February 2014 to September 2016, a total of 189 patients were included in the study, 33 patients with mild OSAHS were excluded, and finally 86 patients in the study group and 70 patients in the control group were included in the final analysis. The main indicators in- cluded the cognitive and functional status. Cognitive status was assessed by nine dimensions： vigilance, attention, memory, working memory, executive, language, insight, mental activity, psychomotor, and intelligence. Func- tional status was assessed using neurological status and functional independence. Secondary measures included sleepiness, fatigue, anxiety and depression, and sleep quality. Result：The age of the study group was higher than the control group, the BMI was higher than the control group, the average hospitalization time was longer than the control group, and all of the difference were statistically significant（all P〈0.05）. The total cognitive status of the two groups was significantly different, and the total cognitive status study group was significantly worse than in- the control group（t= 9. 276,P= 0. 012）. In the nine dimensions of cognitive ability, the study group＇s attention, execution, insight, mental adjustment and intelligence were lower than the control group, and the difference was statistically significant（P〈0. 05）. The functional status of the study group was worse than that of the control group（t=38. 094,P= 0. 000）. There were no significant differences between the two groups in terms of sleepi- ness, fatigue, sleep quality, anxiety and depression（P^0.05）. Conclusion：The cognitive impairment and functional status of stroke patients with OSAHS are significantly worse. OSAHS is a risk factor for poor prognosis in stroke patients.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 脑卒中 认知 功能状态 

分 类 号：R563.8[医药卫生—呼吸系统]