慢性失眠患者认知功能与睡眠质量、血清鸢尾素和脑源性神经营养因子水平的相关性研究  

Relationship between Cognitive Function and Sleep Quality,Serum Irisin and Brain Derived Neurotrophic Factor in Patients with Chronic Insomnia

作　　者：范清雨[1] 杨新利[1] 张桂莲[1] 张茹[1] 展淑琴[1] 王虎清[1] 张蓬勃[2] FAN Qing-yu;YANG Xin-li;ZHANG Gui-lian;ZHANG Ru;ZHAN Shu-qin;WANG Hu-qing;ZHANG Peng-bo(Department of Neurology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;Department of Anesthesiology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院神经内科,西安710004 [2]西安交通大学第二附属医院麻醉科,西安710004

出　　处：《中国临床神经科学》2021年第4期399-405,共7页Chinese Journal of Clinical Neurosciences

摘　　要：目的探讨慢性失眠患者认知功能与主客观睡眠质量、血清鸢尾素和脑源性神经营养因子(BDNF)水平的相关性。方法选取慢性失眠患者67例为慢性失眠组,再按失眠严重程度分为轻、中、重度失眠亚组;另选择同期体检的健康者28例为对照组。两组年龄、性别、受教育年限、体质指数(BMI)、体育活动等级量表得分比较,差异无显著性。用多导睡眠监测、匹兹堡睡眠质量指数(PSQI)评估受试者的主客观睡眠质量,MoCA量表评估认知功能,测定血清鸢尾素和BDNF水平。结果慢性失眠组PSQI得分、睡眠潜伏期、N1期睡眠时间占比(N1%)高于对照组,睡眠效率、N3期睡眠时间占比(N3%)及快速动眼睡眠(REM)%、MoCA量表总分、视空间执行功能、注意力、记忆力评分、血清鸢尾素和BDNF水平低于对照组,差异均有统计学意义(P<0.05)。轻、中和重度慢性失眠亚组的组间MoCA总分及视空间与执行功能、记忆力得分、血清鸢尾素和BDNF水平比较,差异均有统计学意义(均P<0.05);3亚组MoCA量表总分及视空间与执行功能、记忆力、血清鸢尾素和BDNF水平均依次降低(均P<0.05)。相关分析示慢性失眠组MoCA评分与N3%、REM%水平、血清鸢尾素和BDNF呈正相关(P<0.05),与PSQI量表评分、N1%呈负相关(P<0.05)。结论慢性失眠患者认知功能较正常人降低,与睡眠质量下降、睡眠结构紊乱、血清鸢尾素和BDNF水平降低有关。Aim To investigate the correlation between cognitive function and sleep quality,serum irisin,rain derived neurotrophic factor(BDNF)in patients with chronic insomnia.Methods Sixty-seven patients with chronic insomnia were selected,and 28 healthy people matched with age,gender,education level and PARS-3 score during the same period were selected as the control group.Polysomnography,Pittsburgh Sleep Quality Index(PSQI)and MoCA scale were used to evaluate the cognitive function.Serum irisin and BDNF levels were measured.Results PSQI score,sleep latency,N1%of chronic insomnia patients were higher,sleep efficiency,N3%,REM%,Mo CA score,visual space and executive function,attention,memory score,serum irisin and BDNF of chronic insomnia patients were lower than those of the control group,the difference was statistically significant(P<0.05).The grouping study showed that there were significant differences in Mo CA,visual space and executive function,memory score,serum irisin and BDNF levels among the three group(P<0.05).The MOCA,visual space and executive function,memory score,serum irisin and BDNF levels in the three groups were decreased in turn(P<0.05).Correlation analysis showed that Mo CA score was positively correlated with N3%,REM%,irisin and BDNF level,and negatively correlated with PSQI score,N1%(P<0.05).Conclusion The cognitive function of patients with chronic insomnia is lower than that of normal people,which is related to the decline of sleep quality,the disorder of sleep structure and the decrease of serum irisin and BDNF level.

关 键 词：慢性失眠 认知功能 睡眠质量 睡眠结构 血清鸢尾素 脑源性神经营养因子 

分 类 号：R741[医药卫生—神经病学与精神病学] R749[医药卫生—临床医学]