阻塞性睡眠呼吸暂停低通气综合征患者的心理人格特征研究

Study on the psychologic status and personality traits of 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（obstructive sleep apnea hypopnea syndrome,OSAHS）患者的基本心理人格特征.方法 应用明尼苏达多相个性调查表（Minnesota Muhiphasic Personality Inventory,MMPI）进行调查,比较2013年5月-2014年2月于天津市第一中心医院睡眠中心115例OSAHS患者和42名健康对照者的心理人格特征,其中OSAHS患者按睡眠呼吸暂停低通气指数（apnea-hypopnea index,AHI）及最低血氧分别分成重度及轻中度OSAHS组和重度低氧血症及轻中度低氧血症组.结果 OSAHS患者在D抑郁量表、Hy癔病量表、Mf性度量表、Pa妄想量表及附加量表中的A焦虑量表、Es自我力量量表的T分上与健康对照者的差异有统计学意义,其中D、Hy、Pa、A、Es量表OSAHS患者的T平均分值均高于健康对照组,Mf量表OSAHS患者T平均分值均低于健康对照组.比较56例重度OSAHS患者与59例轻中度OSAHS患者的MMPI测试结果,在D抑郁量表、Pa妄想量表、Pt精神衰弱量表,附加量表中的A焦虑量表、MAS外显性焦虑量表、Dy依赖性量表T分的差异有统计学意义,且中重度OSAHS患者T平均分值均高于轻中度OSAHS患者.比较24例重度低氧血症患者与健康对照组的MMPI测试结果,在D抑郁量表、Mf性度量表、Pt精神衰弱量表,Es自我力量量表在T分上的差异具有统计学意义,其中D、Pt、Es量表中重度低氧血症患者的T平均分值均高于健康对照组,Mf量表重度低氧血症患者T平均分值低于健康对照组.比较24例重度低氧血症患者与91例轻中度低氧血症患者的MMPI测试结果,在Pt精神衰弱量表重度低氧血症组T分高于轻中度低氧血症组,且差异具有统计学意义.相关性分析表明AHI与抑郁量表D（r=0.437,P=0.000）、妄想量表Pa（r =0.416,P=0.000）呈正相关,由此表明AHI越高者,抑郁与妄想症状越严重.结论 OSAHS患者与健康人群相比具有特殊的人格特点.OSAHS患者总体上有情绪抑郁、不适、心理问题躯体化、过分敏感、紧张等问题,并且OSAHS严重程度与其心理人格特征有一定相关性.重度OSAHS患者较轻中度OSAHS患者压抑、悲观、焦虑、顺应不良、情绪不安等表现更为明显.低氧血症严重程度与患者的个性特质情况关系并不密切.

Objective To explore the personality and character of obstructive sleep apnea hypopnea syndrome （OSAHS） patients.Methods Subjects,recruited from May 2013 to February 2014,were assigned to the severe OSAHS group （56 cases）,mild-moderate OSAHS group （59 cases）,and control group（42 cases） on the basis of apnea hyponea index （AHI）.Subjects were assigned to the severe hypoxemia group（24 cases）,mild-moderate hypoxemia group （91 cases） on the basis of PaO2.The psychological aspects of subjects were assessed by using the Minnesota multiphasic personality inventory （MMPI）.Results Compared between OSAHS group and the control group,differences of 6 clinical scales depression （D）,hysteria （Hy）,masculinity（Mf）,paranoia （Pa）,anxiety （A）,ego strength （Es） were signifieant（t value was 2.609,2.133,-2.294,2.520,2.041,2.675 respectively,all P 〈 0.05）.The scores of OSAHS group were higher than the control group on five clinical scales,depression （D）,hysteria （Hy）,paranoia （Pa）,anxiety （A）,ego strength （ES）.The scores of OSAHS group were lower than the control group on clinical scale masculinity （Mf）.Compared between severe OSAHS group and mild-moderate OSAHS group,differences of 6 clinical scales depression （D）,paranoia （Pa）,psychasthenia （Pt） anxiety （A）,manifest anxiety scale （MAS）,dependency （Dy） were significant （t value was 2.460,2.086,2.181,2.121,2.954,1.982,respectively）.The scores of severe OSAHS group were all higher than the mild-moderate OSAHS group on these six clinical scales.Compared between severe hypoxemia group and the contrast group,differences of 4 clinical scales depression （D）,masculinity （Mf）,paranoia （Pa）,ego strength （Es） were significant （t value was respectively 2.992,-2.221,2.164,2.165,all P 〈 0.05）.The scores of severe hypoxemia group were higher than the control group on 3 clinical scales,depression （D）,paranoia （Pa）,ego strength （ES）,and lower than the control group on clinical scale masculinity （Mf）.Compared between severe hypoxemia group and mild-moderate hypoxemia group,psychasthenia （Pt） were significant（t value was 1.984）.The scores of severe hypoxemia group were higher.Conclusions Compared with health people,OSAHS patients have special personality and character.The degree of OSAHS can infect the personality and character of OSAHS patients.