老年中重度阻塞性睡眠呼吸暂停综合征患者的睡眠结构特征与认知障碍的关系研究  

Relationship between sleep structure and cognitive impairment in elderly patients with moderate to severe obstructive sleep apnea syndrome

作　　者：竺飞燕[1] 王云玲 金鑫[1] 眭淑彦 张震中[1] ZHU Feiyan;WANG Yunling;JIN Xin;SUI Shuyan;ZHANG Zhenzhong(Department of Neurology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院神经内科,杭州310012

出　　处：《浙江医学》2021年第22期2422-2425,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019KY343)。

摘　　要：目的探讨老年中重度阻塞性睡眠呼吸暂停综合征(OSAS)患者睡眠结构特征与认知障碍的关系。方法选择2019年1月至2020年7月浙江省立同德医院诊断为中重度OSAS的老年患者30例为OSAS组,并选择同期健康志愿者30例为对照组。采用多导睡眠监测(PSG)记录和比较PSG参数[包括总睡眠时间、睡眠潜伏时间、睡眠效率、非快速眼动(NREM)1占比、NREM 2占比、NREM3占比、快速眼动(REM)占比、总睡眠呼吸暂停低通气指数(AHI)、AHI-REM、AHI-NREM、平均血氧饱和度、最低血氧饱和度],采用简易精神状态量表(MMSE)及蒙特利尔认知量表(MoCA)评估认知功能,采用Epworth嗜睡量表(ESS)评估日间嗜睡程度,并做相关性分析。结果OSAS组患者的总睡眠时间、睡眠潜伏时间、睡眠效率、NREM3占比、REM占比、平均血氧饱和度、最低血氧饱和度均低于对照组,NREM1占比高于对照组,差异均有统计学意义(均P<0.05)。OSAS组的MoCA总分及其中视空间与执行、注意力、语言、抽象、延迟回忆、定向单项得分均低于对照组,差异均有统计学意义(均P<0.05)。OSAS组的MoCA总分与受教育年限、睡眠效率、NREM3占比、平均血氧饱和度及最低血氧饱和度呈正相关(均P<0.05),与年龄、总AHI、AHI-REM、AHI-NREM及ESS得分呈负相关(均P<0.05)。多元线性回归分析显示,MoCA总分与年龄、受教育年限、NREM3占比、平均血氧饱和度呈线性相关。结论老年中重度OSAS患者存在睡眠结构紊乱和认知障碍,其中NREM3占比、平均血氧饱和度是认知障碍的主要影响因素。ion,delayed recall and orientation were significantly lower in OSAS group than those in control group(P<0.05).Pearson correlation analysis showed that MoCA score in OSAS group was positively correlated with education level,sleep efficiency,proportion of NREM3,mean oxygen saturation and lowest oxygen saturation(P<0.05),and negatively correlated with age,total AHI,AHI-REM,AHI-NREM and ESS scores(P<0.05).Multiple linear regression analysis showed that MoCA score was correlated with age,years of education level,the proportion of NREM3 and mean oxygen saturation.Conclusion The elderly patients with moderate to severe OSAS are characterized by disordered sleep structure and have cognitive impairment,the proportion of NREM3 and mean oxygen saturation are the major factors contributing to the cognitive impairment.

关 键 词：阻塞性睡眠呼吸暂停综合征 认知障碍 睡眠结构 睡眠呼吸监测 

分 类 号：R766[医药卫生—耳鼻咽喉科]