急性脑梗死患者非快速眼球运动期睡眠障碍对认知功能的影响

Influence of non-rapid eye movement sleep disorder on the cognitive function of patients with acute cerebral infarction

目的探讨急性脑梗死患者非快速眼球运动期(NREM)睡眠障碍与认知功能的关系。方法利用蒙特利尔认知评估量表(MoCA)、简易智能状态量表(MMSE)、多导睡眠图对河北北方学院附属第一医院56例急性脑梗死伴NREM睡眠障碍患者(病例组)和同期32例急性脑梗死患者(对照组)的认知功能进行评估和比较。结果病例组NREM睡眠S1期[(155.58±47.94)min]长于对照组[(110.00±38.76)min],NREM睡眠S2期[(80.75±33.05)min]、S3+S4期[(15.01±12.79)min]均短于对照组[(120.02±28.08)、(66.32±18.92)min],差异均有高度统计学意义(P<0.01)。对照组MoCA中视空间与执行总分[(4.61±0.43)分],命名总分[(3.00±0.01)分]均高于病例组[(2.36±0.98)、(2.38±0.61)分],差异均有统计学意义(P<0.05或P<0.01)。病例组时间定向[(2.76±1.51)分]、注意计算[(2.50±1.96)分]、延迟记忆[(1.50±0.62)分]、结构能力[(0.51±0.43)分]得分低于对照组[(4.76±0.38)、(2.62±0.42)、(2.65±0.42)、(1.00±0.00)分],差异有统计学意义(P<0.05或P<0.01)。结论急性脑梗死患者NREM睡眠S2期、S3+S4期时间缩短,认知功能下降,睡眠结构变化与认知功能可能存在相关性。

Objective To study the correlation between non-rapid eye movement（NREM） sleep disorder and cognitive function in patients with acute cerebral infarction. Methods Cognitive function of 56 cases of patients with acute cerebral infarction and NREM sleep disorders（case group） in the First Hospital Affiliated to Hebei North University and 32cases of patients with acute cerebral infarction in the same period（control group） were assessed and compared by the Montreal cognitive assessment scale（MoCA）, simple intelligent state scale（MMSE）, and polysomnogram. Results The stage S1of NREM sleep in case group [（155.58±47.94） min] was longer than that of control group [（110.00±38.76） min],stage S2of NREM sleep [（80.75±33.05） min], stage S3＋S4[（15.01±12.79） min] were shorter than those of control group[（120.02±28.08）,（66.32±18.92） min], the differences were statistically significant（P〈0.01）. The MoCA scores in visuospatial and executive of control group [（4.61±0.43） points], naming score [（3.00±0.01） points] were higher than those of case group [（2.36±0.98）,（2.38±0.61） points], the differences were statistically significant（P〈0.05）. Scores of time orientation [（2.76±1.51） points], attention of calculation [（2.50±1.96） points], delayed memory [（1.50±0.62） points], structural capabilities [（0.51±0.43） points] of case group were lower than those of control group [（4.76±0.38）,（2.62±0.42）,（2.65±0.42）,（1.00±0.00） points], the differences were statistically significant（P〈0.05 or P〈0.01）. Conclusion The patients with acute cerebral infarction have shorter NREM sleep time in stage S2and S3＋S4and cognitive decline, there may be a correlation between sleep structure changes and cognitive function.