重度阻塞性睡眠呼吸暂停低通气综合征患者记忆和执行功能状况及记忆功能与睡眠呼吸的关系研究

Status of Memory and Executive Function of patients with Severe OSAHS and the Relationship between Memory Function and Sleep Breathing

目的分析重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者记忆和执行功能状况及记忆功能与睡眠呼吸的关系。方法选取2014年3月—2016年1月在海南医学院第二附属医院接受治疗的重度OSAHS患者30例作为研究组,另选取同期体检健康者30例作为对照组。比较两组受试者整体认知功能、记忆功能、执行功能及睡眠呼吸指标,并分析记忆功能指标与重度OSAHS患者睡眠呼吸指标的关系。结果研究组患者蒙特利尔认知功能评定量表(MoCA)评分、数字广度顺背评分、数字广度倒背评分、图片回忆评分、理解记忆评分、视觉再生评分及2-back测试正确率高于对照组,Stroop干扰时间和2-back反应时间短于对照组,威斯康辛卡片(WCST)测试正确数和分类数多于对照组、随机错误数和连续错误数少于对照组(P<0.05);两组患者0-back测试正确率和反应时间比较,差异无统计学意义(P>0.05)。研究组患者呼吸暂停低通气指数(AHI)、氧减指数及血氧饱和度<90%占监测时间的百分比(Sa T90)高于对照组,最低血氧饱和度(SaO_2)和平均Sa O2低于对照组(P<0.05);两组受试者快动眼睡眠时间百分比(REM%)比较,差异无统计学意义(P>0.05)。相关性分析结果显示,数字广度顺背评分与重度OSAHS患者Sa T90呈负相关(rs=-0.295,P<0.05);数字广度倒背评分与重度OSAHS患者Sa T90呈负相关(rs=-0.319,P<0.05),与平均Sa O2呈正相关(rs=0.304,P<0.05);理解记忆评分与重度OSAHS患者REM%、平均SaO_2呈正相关(r值分别为0.286、0.314,P<0.05),与Sa T90呈负相关(r=-0.303,P<0.05);视觉再生评分与重度OSAHS患者Sa T90呈负相关(r=-0.304,P<0.05),与平均SaO_2呈正相关(r=0.328,P<0.05)。结论重度OSAHS患者整体认知功能及记忆、执行功能受损,且记忆功能受损与其睡眠呼吸障碍关。

Objective To analyze the status of memory and executive function of patients with severe OSAHS and the relationship between memory function and sleep breathing. Methods From March 2014 to January 2016 in the Second Affiliated Hospital of Hainan Medical College,a total of 30 patients with OSAHS were selected as study group,a total of 30 healthy cases for physical examination were selected as control group. Overall cognitive function, memory function, executive function and sleep breathing related index were compared between the two groups,and the relationship between memory function and sleep breathing of patients with OSAHS were analyzed. Results Mo CA score,sequential recite of digit span score,reverse sequential recite of digit span score, imaging memory score, understanding memory score, visual reproduction score and 2-back test accuracy rate of study group were statistically significantly higher than those of control group,Stroop interfering time and 2-back response time of study group were statistically significantly shorter than those of control group,accurate number and classified number of WCST test of study group were statistically significantly more than those of control group,while random false number and continuous false number of WCST test of study group were statistically significantly less than those of control group（ P 〈0. 05）; no statistically significant significant differences of accuracy rate or response time of 0-back test was found between thetwo groups（ P 〉 0. 05）. Apnea hypopnea index（ AHI）,oxygen desaturation index（ ODI） and percent of Sa O2 less than 90%during the monitoring（ Sa T90） of study group were statistically significantly higher than those of control group,while the lowest Sa O2 and mean Sa O2 of study group were statistically significantly lower than those of control group（ P 〈 0. 05）; no statistically significantly differences of percent of rapid eye- movement sleep time（ REM%） was found between the two groups（ P 〉0. 05）. Correlation analysis results showed that, sequential recite of digit span score was negatively correlated with Sa T90 of patients with severe OSAHS（ rs=- 0. 295, P 〈 0. 05）; reverse sequential recite of digit span score was was negatively correlated with Sa T90 of patients with severe OSAHS（ rs=- 0. 319,P 〈 0. 05）,was positively correlated with mean SaO2（ rs=0. 304,P 〈 0. 05）; understanding memory score was positively correlated with REM%（ r = 0. 286,P 〈 0. 05） and mean SaO2（ r = 0. 314,P 〈 0. 05） of patients with severe OSAHS,respectively,was negatively correlated with Sa T90（ r =- 0. 303,P 〈0. 05）; visual reproduction score was negatively correlated with Sa T90 of patients with severe OSAHS（ r =- 0. 304,P 〈 0. 05）,was positively correlated with mean SaO2（ r = 0. 328,P 〈 0. 05）. Conclusion The overall cognitive function,memory function and executive function of patients with severe OSAHS are damaged,meanwhile memory function damage is correlated with the sleep breathing disorder.