原发性失眠患者神经心理及认知功能研究

A study of neuropsychology and cognitive ability among primary insomnia patients

目的探讨原发性失眠(PI)患者神经心理、认知功能的改变及其与失眠严重程度的相关性。方法采用病例-对照研究,符合ICD-10诊断标准的原发性失眠患者40名,对照组为正常睡眠者(NS)50名。两组均行匹兹堡睡眠指数(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、WHO-UCLA词语学习、划销实验量表测定,并对结果进行统计学分析。结果 PI组PSQI、HAMA、HAMD评分均高于对照组,词语学习能力、数字划销工作效率下降(P<0.05)。PI组患者睡眠质量下降与焦虑情绪有明显正相关性(r=0.350),学历、病程及HAMD评分与睡眠质量存在线性关系(α=0.1,F=13.44,P<0.05)。对影响认知功能相关因素进行回归分析,睡眠质量及HAMA评分与认知功能有显著相关性(α=0.1,F=12.943,P<0.05)。结论 PI患者睡眠质量、认知功能下降,焦虑、抑郁情绪明显。睡眠质量与焦虑情绪显著相关,睡眠质量的下降可引起认知功能下降。

Objective To evaluate the neuropsychology and cognitive ability changes in patients with primary insomnia （ PI）, and to investigate the relationship between the severity of insomnia and these changes. Methods A case-control study was performed among 40 patients diagnosed with PI according to International Classification of Diseases-10 and 50 disease-free controls. Pittsburgh Sleep Quality Index （PSQI）, Hamilton Anxiety Scale （HAMA）, Hamilton Depression Scale （HAMD）, WHO-UCLA auditory verbal learn- ing test, and cancellation test were used to evaluate the neuropsychology and cognitive ability of all patients. Statistical analysis was performed on the results of these tests. Results The PSQI, HAMA, and HAMD scores of the PI group were higher than those of the control group, while the scores of verbal learning and cancellation tests were lower in the PI group （ P 〈 0.05 ）. In the PI group, the decline in sleep quality was positively correlated with anxiety （ r = 0. 350） ; a linear relationship was found between sleep quality and the following factors ： degree of education, course of disease, and HAMD score （α = 0.1, F = 13.44, P 〈 0.05 ）. Regression analysis was performed to find factors that affect cognitive ability; sleep quality and HAMA score were both significantly correlated with the cog- nitive ability （α= 0. 1, F = 12. 943, P 〈 0.05 ）. Conclusions PI patients suffer decline in sleep quality and cognitive ability and show obvious depression and anxiety. Decline in sleep quality is significantly correlated with anxiety. Decline in sleep quality may re- duce cognitive ability.