OSAHS患者认知功能的变化与生活质量的关系

To evaluate cognitive function and the relationship between the quality of life and cognition disorders in patients with obstructive sleep apnea hypopnea syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者认知功能的变化及与生活质量的关系。方法选择在宣武医院就诊的OSAHS患者90例,根据呼吸暂停低通气指数分为轻、中、重组各30例,采集记录简易智能精神状态检查量表(MMSE)、Epworth嗜睡量表(ESS)及生活质量量表(SF-36)。结果①各组OSAHS患者年龄、性别、体重指数、受教育程度比较,P>0.05。②各组OSAHS患者呼吸暂停低通气指数(AHI)、最长呼吸暂停时间(LAT)、血氧饱和度小于0.9时间占睡眠时间百分比9SLT 90%)及夜间最低血氧饱和度(SaO2m in)比较,P<0.01。③重度OSAHS组MMSE总分明显低于轻、中度OS-AHS组,P<0.05;在记忆力、注意力和计算力、回忆能力得分明显低于轻、中度OSAHS组,P<0.01。轻、中度OSAHS组MMSE总分及在记忆力、注意力和计算力、回忆能力得分比较,P>0.05。④各组OSAHS患者ESS评分比较,P<0.01。重度OSAHS组患者SF-36总分明显低于轻、中度OSAHS组,P<0.01;轻、中度OSAHS组患者SF-36总分比较,P>0.05。⑤MMSE总分与SaO2m in呈正相关,P<0.01,与AHI、LAT、SLT 90%、ESS呈负相关,P<0.01;MMSE总分与SF-36总分正相关,P<0.01。结论①重度OSAHS患者较轻、中度OSAHS患者认知功能明显下降,主要表现在学习、记忆、计算、结构方面的损害。②OSAHS患者认知功能损害与疾病严重程度及白天过度嗜睡密切相关。③OSAHS患者认知功能改变可影响OSAHS患者的生活质量。

Objective To asscess cognitive changes of patients with obstructive sleep apnea-hypopnea syndrome and the relation-ship between the quality of life and cognition disorders. Methyls The data of 90 patients with OSAHS in Xuanwu hospital were investigated in our study. All patients were divided into three groups, according to apnea-hypopnea index （AHI） ： mild group, moderate group and severe group. The cognitive function was evaluated by MMSE. The quality of life was assessed by the short-form （SF-36）. The excessive daytime sleepiness was assessed by the epworth sleepiness scale （ESS）. Results 1. There was no significant difference in age, sex, BMI and education degree in the three groups （P 〉0.05 ）. 2. The parameters, including AHI, longest apnea time （LAT） and percentage of time spend when oxygen saturation lower than 0.9（SLT90% ） were significantly higher in the severe OSAHS group than those in the mild and moderate groups （ P 〈 0.01）. Minima satuation of blood oxygen （SaO2 min） in the severe OSAHS group was significantly lower than that in the mild and moderate groups （ P 〈0.01）. 3. The total score of MMSE and subtest scores of MMSE in leaning, memory, calculation and constructive function were significantly lower in the severe OSAHS group than those in the mild and moderate groups （ P 〈 0.05）. 4. The score of ESS in the severe OSAHS group was significantly higher than that in the mild and moderate groups （P 〈0.01）, and also the score was higher in the moderate OSAHS group than that in the mild OSAHS group （ P 〈 0.01）. The score of SF-36 in the severe OSAHS group was significantly lower than that in the mild and moderate groups （P 〈0.01）. There was no significant difference in score of SF-36 between the mild and moderate OSAHS groups （ P 〉0.05）. 5. In patients with OSAHS, the score of MMSE was positively correlated with the SaO2 min （P 〈0.01） and was negatively correlated with AHI, LAT, SLT90% and ESS （P 〈 0.01）. The total scorc of MMSE was positively correlated with the score of SF-36 （ P 〈 0.05）. Conclusion 1. There is an obvious decrease in cognitive function in patients with severe OSAHS, especially in leaning, memory, calculation and constructive function. 2. There is the excessive daytime sleepiness in patients with OSAHS . The severity of OSAHS and the level of excessive daytime sleepiness are markedly correlated with the cognitive dysfunction. 3. The changes of quality of life are influenced by their cognitive dysfunction.