阿尔茨海默病认知功能与睡眠质量关系的探讨  

Relationship between cognitive function and sleep quality in Alzheimer's disease

作　　者：严颜 张俊磊 倪敬年[1] 李婷[1] 时晶[1] 田金洲[1] 魏明清[1] Yan Yan;Zhang Junlei;Ni Jingnian;Li Ting;Shi Jing;Tian Jinzhou;Wei Mingqing(Third Department of Encephalopathy,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院脑病三科,100700

出　　处：《中华老年心脑血管病杂志》2025年第4期440-444,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：解码中医协同攻关项目(BZY-JMZY-2022-002);中医学与中药学科创新引智基地项目(2024-JYB-KYPT-07)。

摘　　要：目的探讨阿尔茨海默病(Alzheimer's disease,AD)患者认知功能与睡眠质量的关系。方法采用病例对照研究方法,选取2024年5~12月东直门医院脑病科三科收治的患者151例,轻中度AD患者纳入AD组(59例),认知正常患者纳入对照组(92例)。所有患者完成神经心理学测评和睡眠质量测评,包括简易智能状态检查量表(mini-mental state examination,MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、匹兹堡睡眠质量指数量表(Pittsburghsleepqualityindex,PSQI)等。比较2组一般临床资料以及睡眠质量;采用Spearman相关性分析AD患者认知功能与睡眠质量的关系。结果AD组受教育程度、MMSE评分、MoCA评分、即刻故事回忆评分、延迟故事回忆评分、画钟试验评分、波士顿命名测试评分显著低于正常组,日常生活活动能力量表评分显著高于正常组(P<0.05,P<0.01)。AD组PSQI总分、睡眠效率评分、夜间睡眠障碍评分、日间功能障碍评分显著高于正常组,差异有统计学意义(P<0.05,P<0.01)。AD患者睡眠总时间与延迟故事回忆评分、画钟试验评分呈正相关(r=0.300,P=0.021;r=0.308,P=0.018);AD患者催眠药物与MMSE评分、即刻故事回忆评分、延迟故事回忆评分呈负相关,与日常生活活动能力量表评分呈正相关(r=一0.320,P=0.013;r=一0.400,P=0.002;r=一0.331,P=0.010;r=0.355,P=0.006)。多元线性回归分析显示,苯二氮[艹卓]类催眠药物和受教育程度是AD患者认知功能的独立影响因素(P<0.05,P<0.01)。结论AD患者的睡眠质量与认知功能密切相关,表现为睡眠质量下降,睡眠效率降低,夜间睡眠障碍加重及日间功能障碍加重。苯二氮[艹卓]类催眠药物的使用可能会加重AD患者的认知损害,建议AD患者应谨慎使用此类药物。Objective To investigate the relationship between cognitive function and sleep quality in patients with Alzheimer's disease(AD).Methods A case-control trial was conducted on 151 patients admitted to our department from May 2024 to December 2024.The patients with mild-tomoderate AD were assigned into the AD group(59 cases),and the cognitively normal patients into the control group(92 cases).All patients received neuropsychological assessment and sleep quality evaluation,including mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA)and Pittsburgh sleep quality index(PSQI).The general clinical data and sleep quality were compared between the two groups.Spearman correlation analysis was applied to analyze the relationship between cognitive function and sleep quality in the AD patients.Results The education level,MMSE score,MoCA score,instant story recall(ISR)score,delayed story recall(DSR)score,clock dawning test(CDT)score and Boston naming test score were significantly lower,while the activity of daily living(ADL)score was obviously higher in the AD group than the cognitively normal group(P<0.05,P<0.01).The AD patients had notably higher total score of PSQI and scores of sleep efficiency,nocturnal sleep disturbance and daytime dysfunction than the cognitively normal patients(P<o.05,P<0.01).In the AD patients,the total sleep time was positively correlated with the DSR score and the CDT score(r=0.300,P=0.021;r=0.308,P=0.018);hypnotic medication was negatively correlated with MMSE score,ISR score,and DSR score,and positively with ADL score(r=-0.320,P=0.013;r=-0.400,P=0.002;r=-0.331,P=0.010;r=0.355,P=0.006).Multiple linear regression analysis showed that benzodiazepines use and education level were independent influencing factors for cognitive function in the AD patients(P<0.05,P<0.01).Conclusion In AD patients,sleep quality is closely associated with cognitive function,as manifested by decreased sleep quality,reduced sleep efficiency,and worsened nocturnal sleep disturbances and daytime dysfunction.A

关 键 词：阿尔茨海默病 睡眠障碍 认知 数据相关性 

分 类 号：R74[医药卫生—神经病学与精神病学]