慢性阻塞性肺疾病(COPD)患者睡眠与负性心理及认知功能的相关性

Correlation between sleep and negative psychological and cognitive dysfunction in patients with chronic obstructive pulmonary disease(COPD)

目的探讨慢性阻塞性肺疾病(COPD)患者睡眠及血氧监测与负性心理及认知功能障碍水平的相关性。方法选择2017年4月~2019年4月间我院治疗的123名COPD患者,根据患者肺功能结果中一秒用力呼气容积/用力肺活量(FEV1/FVC),一秒用力呼气容积(FEV1)占预计值百分比将其分为A组(轻度,n=34),B组(中度,n=39),C组(重度,n=35),D组(极重度,n=15),比较四组患者睡眠监测指标,焦虑自评量表评分(SAS),抑郁自评量表评分(SDS)以及简易智能状态量表评分(MMSE)、蒙特利尔认知评估量表评分(MoCA),采用spearman相关性分析睡眠监测指标和患者心理及认知功能的相关性。结果D组患者I+II期,呼吸暂停通气指数(AHI),微觉醒指数(MAI),动脉血氧饱和度<90%的时间占总睡眠时间的百分比(TS90%),SAS和SDS评分显著高于A,B,C三组,快速眼动睡眠占总睡眠时间比例(REM),最低脉氧饱和度(LSaO2),MMSE和MoCA评分显著低于A,B,C三组(P<0.05),四组患者上述指标组间比较差异有统计学意义(P<0.05);患者负性心理程度与浅睡眠时间,AHI,MAI和TS90%呈明显正相关,与REM呈明显负相关(P<0.05),认知功能障碍程度与浅睡眠时间AHI,MAI和TS90%呈明显负相关,与REM呈明显正相关(P<0.05)。结论COPD患者存在睡眠质量下降,其睡眠及血氧指标与负性心理和认知功能障碍水平有关。

Objective To investigate the correlation between sleep and blood oxygen monitoring and negative psychological and cognitive dysfunction in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 123 COPD patients treated in our hospital from April 2017 to April 2019 were selected.According to the pulmonary function results of the patient,one-second forced expiratory volume/forced vital capacity(FEV1/FVC)and one-second forced expiratory volume(FEV1)As a percentage of the predicted value and divided them into group A(mild,n=34),group B(moderate,n=39),group C(severe,n=35),and group D(very severe,n=15),Comparing sleep monitoring indicators,anxiety self-rating scale(SAS),depression self-rating scale(SDS),simple intelligent state scale(MMSE),and Montreal cognitive assessment scale(MoCA),Spearman correlation was used to analyze the correlation between sleep monitoring indicators and patients'psychological and cognitive functions.Results Patients in group D had stage I+II,apnea ventilation index(AHI),micro-awakening index(MAI),arterial oxygen saturation<90%of the total sleep time(TS90%),and SAS and SDS scores were significant.Higher than the A,B,and C groups,the ratio of rapid eye movement sleep to total sleep time(REM),the lowest pulse oxygen saturation(LSaO2),and the MMSE and MoCA scores were significantly lower than those of the A,B,and C groups(P<0.05).He comparison of the above indicators between the four groups of patients was statistically significant(P<0.05).The negative psychological level of patients was significantly positively correlated with light sleep time,AHI,MAI and TS90%,and significantly negatively correlated with REM(P<0.05).The degree of cognitive dysfunction was significantly negatively correlated with light sleep time AHI,MAI and TS90%,and significantly positively correlated with REM(P<0.05).Conclusion COPD patients have a certain decline in sleep quality,and their sleep and blood oxygen indicators are strongly correlated with the level of negative mood and cognitive impairment.