维生素D联合右佐匹克隆治疗老年慢阻肺合并睡眠障碍疗效及对认知功能的保护作用研究

Efficacy of Vitamin D combined with eszopiclone in treatment of elderly chronic obstructive pulmonary disease patients complicated with sleep disorder and its protective effect on cognitive function

目的探讨维生素D联合右佐匹克隆治疗老年慢阻肺合并睡眠障碍疗效及对认知功能的保护作用。方法收集140例老年慢阻肺合并睡眠障碍患者作为研究对象,随机分为对照组和研究组,每组70例。对照组给予右佐匹克隆治疗,研究组给予维生素D联合右佐匹克隆治疗。采用匹茨堡睡眠质量指数(PSQI)评估睡眠质量。采用简易精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估认知功能。比较两组睡眠障碍临床疗效、睡眠监测指标、PSQI评分、认知功能和神经营养因子水平。结果研究组睡眠障碍治疗总有效率高于对照组(92.8%vs 80.0%,P<0.05)。睡眠监测指标显示,研究组治疗后总睡眠时间长于对照组[(371.77±27.22)min vs(334.71±28.80 min)],觉醒时间和觉醒次数少于对照组[(32.51±3.89)min vs(46.88±7.32)min,(1.36±0.51)次vs(3.11±0.77)次,P<0.05]。治疗前、治疗后1月和治疗后3月时,不同时间点PSQI评分差异有统计学意义(P<0.05),研究组与对照组PSQI评分变化趋势差异有统计学意义,研究组降低更明显[(15.78±2.02)分vs(15.67±2.05)分,(9.31±2.01)分vs(11.60±2.04)分,(7.60±0.95)分vs(9.40±1.21)分,P<0.05]。研究组治疗后MMSE评分和MoCA评分高于对照组[(28.24±0.92)分vs(26.24±1.53)分,(27.88±1.23)分vs(25.21±1.02)分],脑源性神经生长因子(BDNF)和神经生长因子(NGF)水平高于对照组[(672.29±66.60)pg/mL vs(626.89±55.46)pg/mL,(31.49±5.62)pg/mL vs(23.75±5.18)pg/mL,P<0.05]。结论维生素D联合右佐匹克隆治疗老年慢阻肺合并睡眠障碍疗效良好,而且对认知功能具有一定程度的保护作用。

Objective To explore the efficacy of Vitamin D combined with eszopiclone in treatment of elderly chronic obstructive pulmonary disease patients(COPD)complicated with sleep disorder and its protective effect on cognitive function.Methods 140 elderly COPD patients complicated with sleep disorder were selected as research objects to be randomly divided into the control group and the study group,with 70 cases in each group.The control group was treated with eszopiclone,while the study group was treated with vitamin D combined with eszopiclonee.Pittsburgh Sleep Quality Index(PSQI)was used to evaluate sleep quality.Cognitive function was assessed by the Mini Mental State Inventory(MMSE)and Montreal Cognitive Assessment(MoCA).The clinical efficacy,sleep monitoring indicators,PSQI score,cognitive function and levels of neurotrophic factors were compared between the two groups.Results The total effective rate of sleep disorder in the study group was higher than that in the control group(92.8%vs 80.0%,P<0.05).The sleep monitoring indicators showed that the study group had longer total sleep time[(371.77±27.22)min vs(334.71±28.80)min],shorter awakening time and less awakening time frequency than those in the control group after treatment[(32.51±3.89)min vs(46.88±7.32)min,(1.36±0.51)times vs(3.11±0.77)times],P<0.05).Before treatment,1 and 3 months after treatment,PSQI scores were different among the time points(P<0.05).There were statistical differences in the change trends of PSQI scores between the two groups,and they deceased more obviously in the study group decreased[(15.78±2.02)points vs(15.67±2.05)points,(9.31±2.01)points vs(11.60±2.04)points,(7.60±0.95)points vs(9.40±1.21)points,P<0.05].After treatment,the MMSE score and MoCA score in the study group were higher than those in the control group[(28.24±0.92)points vs(26.24±1.53)points,(27.88±1.23)points vs(25.21±1.02)points],and the levels of brain derived nerve growth factor(BDNF)and nerve growth factor(NGF)were higher than those in the control group[(672.29±66.60)pg/mL vs(626.89±55.46)pg/mL,(31.49±5.62)pg/mL vs(23.75±5.18)pg/mL,P<0.05].Conclusion Vitamin D combined with eszopiclone is effective in treatment of elderly COPD patients complicated with sleep disorder,and it has a protective effect on cognitive function to a certain extent.