莫达非尼对阻塞性睡眠呼吸暂停低通气综合征患者白天嗜睡及认知功能改善的临床研究  

Clinical Study of Modafinil on Daytime Sleepiness and Cognitive Function Improvement in OSAHS Patients

作　　者：郭斌[1] 范杰 王金凤[1] 惠培林[1] 马薇[1] 张尚丽 谢宇平[1] GUO Bin;FAN Jie;WANG Jinfeng;HUI Peilin;MA Wei;ZHANG Shangli;XIE Yuping(Sleep Medicine Center of Gansu Provincial People′s Hospital/Gansu Provincial Sleep Clinical Medicine Research Center,Lanzhou 730000,China)

机构地区：[1]甘肃省人民医院睡眠医学中心/甘肃省睡眠临床医学研究中心,兰州730000

出　　处：《世界睡眠医学杂志》2023年第10期2255-2259,2263,共6页World Journal of Sleep Medicine

基　　金：国家自然科学基金地区科学基金项目(81560228、82160267);甘肃省科技重点研发计划项目(21YF5FA020);甘肃省青年科技计划项目(21JR7RA637);2021年甘肃省卫生健康委科研计划项目(GSWSKY2021-005);甘肃省人民医院基金项目(18GSSY4-19、18GSSY4-20、21GSSYC-25)。

摘　　要：目的:观察评价莫达非尼(modafinil)对重度OSAHS患者白天嗜睡及认知功能的改善。方法:选取2022年1月至2022年12月甘肃省人民医院就诊并经多导睡眠监测(PSG)初次确诊且未经治疗的重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者98例作为研究对象,随机分为单纯持续气道正压通气(CPAP)组、莫达非尼组、CPAP+莫达非尼组。收集患者的一般临床资料,并采用白天小睡试验对患者白天嗜睡的情况进行评估,采用简易智力状态检查量表(MMSE)进行认知功能评分,比较3组患者的白天嗜睡及认知功能的改善差异,并进行相关因素分析。结果:1)3组的性别、年龄、体质量指数比较,差异均无统计学意义(均P>0.05);2)治疗前,PSG、白天多次小睡及认知量表的评估显示,重度OSAHS合并程度一致的嗜睡及一致的轻度认知障碍,治疗后3组患者的白天嗜睡及认知障碍均有改善,CPAP+莫达非尼对重度OSAHS的白天嗜睡及认知功能改善更明显,并缩短治疗时间。结论:莫达非尼可改善重度OSAHS患者的白天嗜睡及认知功能,联用CPAP治疗可缩短治疗时间,值得临床推广应用。Objective:To observe and evaluate the effects of modafinil on daytime sleepiness and cognitive function in patients with severe obstructive sleep apnea hypopnea syndrom(OSAHS).Methods:A total of 98 patients with severe OSAHS who were first diagnosed and untreated by polysomnography(PSG)in Gansu Provincial People′s Hospital from January 2022 to December 2022 were selected.They were randomly divided intocontinuous positive airway pressure(CPAP)group,modafinil group,and CPAP+modafinil group.The general clinical data of the patients were collected,and daytime sleepiness was assessed by the daytime nap test,and cognitive function was scored by the Mini-mental State Examination(MMSE).The differences in daytime sleepiness and cognitive function improvement among the three groups were compared,and related factors were analyzed.Results:1)There were no significant differences in gender,age and body mass index among the three groups(P>0.05).2)Before treatment,PSG,multiple daytime naps and cognitive scale evaluation showed that severe OSAHS had consistent levels of drowsiness and mild cognitive impairment.After treatment,daytime sleepiness and cognitive impairment of the three groups of patients were improved,and CPAP+modafinil had more obvious improvement on daytime sleepiness and cognitive function of severe OSAHS,and the treatment time was shortened.Conclusion:Modafinil can improve daytime sleepiness and cognitive function in patients with severe OSAHS,and combined with CPAP therapy can shorten the treatment time,which is worthy of clinical promotion and application.

关 键 词：莫达非尼 阻塞性睡眠呼吸暂停低通气综合征(OSAHS) 白天嗜睡 认知功能 

分 类 号：R714.253[医药卫生—妇产科学] R338.63[医药卫生—临床医学]