阻塞性睡眠呼吸暂停低通气综合征患者认知功能和生活质量的关系

Relationship between Quality of Life and the Function of Cognition in Patients with Obstructive Sleep Apnea-hypopnea Syndrome

目的:评估阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者生活质量和认知功能状况,探讨其与多导睡眠监测图(PSG)主要指标的关系。方法:选择2006年7月至2007年4月在兰州大学第一医院就诊经PSG确诊的62例OSAHS患者和32例非OSAHS患者(对照组),用生活质量自评量表、简易智能精神状态量表、Epworth嗜睡量表(ESS)进行评估。结果:OSAHS组生活质量、认知功能评分均低于对照组(63.9±14.7/78.8±4.5、24.6±2.0/27.1±1.3,P均(0.001);生活质量与呼吸紊乱指数(AHI)、ESS呈负相关(r=-0.52、-0.39,P均<0.01),与平均血氧饱和度、最低血氧饱和度呈正相关(r=0.28、0.26,P均(0.05);认知功能与AHI和ESS呈负相关(r=-0.86、-0.51,P均(0.001),与平均血氧饱和度、最低血氧饱和度正相关(r=0.36、0.60,P均<0.01);生活质量与认知功能呈正相关(r=0.54,P(0.01)。结论:OSAHS患者中生活质量和认知功能明显下降,二者存在相关关系。

Objective： To assess the quality of life （QOL） and cognition function in patients with severe obstructive sleep apnea （ OSAHS ） , and to study the relationship between the QOL and severity of OSAHS, excessive daytime sleepiness （EDS ） , cognition disorders. Methods： Sixty-two patients with OSAHS and 32 non-OSAHS patients （ control group） which all diagnosed by polysomnography （ PSG） were chosen from The First Hospital of Lanzhou University, and they were assessed by QOL using the Short-Form 36 Health Survey questionnaire （ SF-36 ） , by EDS using the Epworth sleepiness scale （ ESS）, and for cognition disorders by mini-mental state examination （ MMSE） . The associations between the total score on the SF-36 and the baseline characteristics, PSG parameters, such as ESS score, and MMSE score were examined by simple regression analysis and stepwise multiple regression analysis. Results： The scores of SF-36 and MMSE in OSAHS group were significantly lower than the control group （ 63.9 ＋ 14. 7/78.8 ＋ 4. 5, 24. 6 ＋ 2.0/27. 1 ＋ 1.3, P 〈 0. 001 ） . In patients with OSAHS, the score of SF-36 was negatively correlated with apnea hyponea index （ AHI） and ESS （ r = -0. 52, -0. 39, P 〈0. 01 respectively, ） , and was positively correlated with mean level of SaO2 （ biSaO2, r = 0. 28, P 〈 0. 05 ） , and the lowest SaO2 （ LSaO2, r = 0. 26, P 〈 0. 05 ） . The score of MMSE in OSAHS group was negatively correlated with AHI （r= -0.86, P 〈0.001） and ESS （r= -0.51, P〈 0.001） , was positively correlated with MSaO2 （r=0.36, P〈0.01） and LSaO2 （r=0.60, P〈0.01） . The score of SF-36 was positively correlated with MMSE （ r = 0. 54, P 〈 0. 01 ） . Conclusion： There is an obvious decrease in OSAHS patients with quality of life and cognition function, which was correlated to frequently happened intermittent hypoxemia during the night.