国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2014年
13期
996-1000
,共5页
阻塞性睡眠呼吸暂停低通气综合征%认知功能%事件相关电位P300%蒙特利尔认知评估量表%焦虑%抑郁
阻塞性睡眠呼吸暫停低通氣綜閤徵%認知功能%事件相關電位P300%矇特利爾認知評估量錶%焦慮%抑鬱
조새성수면호흡잠정저통기종합정%인지공능%사건상관전위P300%몽특리이인지평고량표%초필%억욱
Obstructive sleep apnea hypopnea syndrom%Cognitive function%Event related potential P300%The Montreal cognitive assessment scale%Anxiety%Depression
目的 通过事件相关电位中的P300检测并结合神经心理测试量表评价OSAHS患者的轻度认知功能障碍(MCI)及行为改变.方法 前瞻性观察多导睡眠图确诊的10例中度OSAHS患者、26例重度OSAHS患者及17例正常对照,以蒙特利尔认知评估量表(MoCA)评分判断参加者是否存在MCI,并行Epworth嗜睡量表(ESS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、症状自评量表及P300检测.分别比较中、重度OSAHS患者组与正常对照组的认知功能及行为改变.相关分析和多元线性回归分析MoCA评分、P300相关参数及ESS评分的相关性及相关程度.结果 与正常对照组比较,中、重度OSAHS患者在Cz,C3,C4点P300潜伏期明显延长(F分别为4.164,4.018,3.960;P ＜0.05);重度组MoCA评分明显延长(25.42±2.76 vs 27.41±1.80,F=3.954,P＜0.01),MoCA亚项分析重度组记忆/延迟回忆评分(2.81±0.98 vs4.06±0.97,Z＝13.075,P＜0.01)明显降低;中、重度组HAMA评分及重度组HAMD评分明显增加(F分别为3.576,3.487;P＜0.05).Fz,Cz,Pz,C3,C4点P300潜伏期分别与MoCA评分呈负相关(r分别为-0.422,-0.410,-0.374,-0.424,-0.442;P值均＜0.01).Fz点P300波幅与MoCA评分呈负相关(r＝-0.346,P=0.013) ;ESS评分与睡眠呼吸暂停低通气指数、最长呼吸暂停时间呈正相关(r分别为0.409,0.342;P值均＜0.05),与平均手指脉搏血氧饱和度(MSPO2)呈负相关(r＝-0.342,P=0.041),记忆/延迟回忆与最低SPO2(LSPO2)呈正相关(r=0.355,P=0.041).Pz点P300潜伏期及Fz点P300波幅对MoCA评分影响较大.结论 ①中、重度OSAHS患者存在MCI;②中、重度OSAHS患者存在焦虑症状,重度OSAHS患者存在抑郁症状;③P300检测可作为评价OSAHS患者认知功能障碍的电生理指标之一,能早期发现OSAHS患者的认知功能障碍,结合MoCA评分可为临床早期干预提供依据.
目的 通過事件相關電位中的P300檢測併結閤神經心理測試量錶評價OSAHS患者的輕度認知功能障礙(MCI)及行為改變.方法 前瞻性觀察多導睡眠圖確診的10例中度OSAHS患者、26例重度OSAHS患者及17例正常對照,以矇特利爾認知評估量錶(MoCA)評分判斷參加者是否存在MCI,併行Epworth嗜睡量錶(ESS)、漢密爾頓焦慮量錶(HAMA)、漢密爾頓抑鬱量錶(HAMD)、癥狀自評量錶及P300檢測.分彆比較中、重度OSAHS患者組與正常對照組的認知功能及行為改變.相關分析和多元線性迴歸分析MoCA評分、P300相關參數及ESS評分的相關性及相關程度.結果 與正常對照組比較,中、重度OSAHS患者在Cz,C3,C4點P300潛伏期明顯延長(F分彆為4.164,4.018,3.960;P ＜0.05);重度組MoCA評分明顯延長(25.42±2.76 vs 27.41±1.80,F=3.954,P＜0.01),MoCA亞項分析重度組記憶/延遲迴憶評分(2.81±0.98 vs4.06±0.97,Z＝13.075,P＜0.01)明顯降低;中、重度組HAMA評分及重度組HAMD評分明顯增加(F分彆為3.576,3.487;P＜0.05).Fz,Cz,Pz,C3,C4點P300潛伏期分彆與MoCA評分呈負相關(r分彆為-0.422,-0.410,-0.374,-0.424,-0.442;P值均＜0.01).Fz點P300波幅與MoCA評分呈負相關(r＝-0.346,P=0.013) ;ESS評分與睡眠呼吸暫停低通氣指數、最長呼吸暫停時間呈正相關(r分彆為0.409,0.342;P值均＜0.05),與平均手指脈搏血氧飽和度(MSPO2)呈負相關(r＝-0.342,P=0.041),記憶/延遲迴憶與最低SPO2(LSPO2)呈正相關(r=0.355,P=0.041).Pz點P300潛伏期及Fz點P300波幅對MoCA評分影響較大.結論 ①中、重度OSAHS患者存在MCI;②中、重度OSAHS患者存在焦慮癥狀,重度OSAHS患者存在抑鬱癥狀;③P300檢測可作為評價OSAHS患者認知功能障礙的電生理指標之一,能早期髮現OSAHS患者的認知功能障礙,結閤MoCA評分可為臨床早期榦預提供依據.
목적 통과사건상관전위중적P300검측병결합신경심리측시량표평개OSAHS환자적경도인지공능장애(MCI)급행위개변.방법 전첨성관찰다도수면도학진적10례중도OSAHS환자、26례중도OSAHS환자급17례정상대조,이몽특리이인지평고량표(MoCA)평분판단삼가자시부존재MCI,병행Epworth기수량표(ESS)、한밀이돈초필량표(HAMA)、한밀이돈억욱량표(HAMD)、증상자평량표급P300검측.분별비교중、중도OSAHS환자조여정상대조조적인지공능급행위개변.상관분석화다원선성회귀분석MoCA평분、P300상관삼수급ESS평분적상관성급상관정도.결과 여정상대조조비교,중、중도OSAHS환자재Cz,C3,C4점P300잠복기명현연장(F분별위4.164,4.018,3.960;P ＜0.05);중도조MoCA평분명현연장(25.42±2.76 vs 27.41±1.80,F=3.954,P＜0.01),MoCA아항분석중도조기억/연지회억평분(2.81±0.98 vs4.06±0.97,Z＝13.075,P＜0.01)명현강저;중、중도조HAMA평분급중도조HAMD평분명현증가(F분별위3.576,3.487;P＜0.05).Fz,Cz,Pz,C3,C4점P300잠복기분별여MoCA평분정부상관(r분별위-0.422,-0.410,-0.374,-0.424,-0.442;P치균＜0.01).Fz점P300파폭여MoCA평분정부상관(r＝-0.346,P=0.013) ;ESS평분여수면호흡잠정저통기지수、최장호흡잠정시간정정상관(r분별위0.409,0.342;P치균＜0.05),여평균수지맥박혈양포화도(MSPO2)정부상관(r＝-0.342,P=0.041),기억/연지회억여최저SPO2(LSPO2)정정상관(r=0.355,P=0.041).Pz점P300잠복기급Fz점P300파폭대MoCA평분영향교대.결론 ①중、중도OSAHS환자존재MCI;②중、중도OSAHS환자존재초필증상,중도OSAHS환자존재억욱증상;③P300검측가작위평개OSAHS환자인지공능장애적전생리지표지일,능조기발현OSAHS환자적인지공능장애,결합MoCA평분가위림상조기간예제공의거.
Objective To investigate the mild cognitive impairment and behavior changes measured by neuropsychological test scale evaluation and the P300 of ERP in the patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods A prospective study with 10 moderate to 26 severe OSAHS patients and 17 controls were carried out to determine whether the participants have mild cognitive impairment (MCI) by Montreal cognitive assessment scale (MoCA).Parallel Epworth sleepiness scale (ESS),Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),symptom checklist 90 and P300,respectively,in patients with moderate,severe OSAHS group and normal control group to compare their cognitive function and behavior change.Correlation and multiple linear regression analysis between MoCA score,P300 parameters and the correlation with ESS score.Results In moderate to severe OSAHS patients in Cz,C3,C4,P300 latency was significantly prolonged compared with normal control group (F =4.164,4.018,3.960,P ＜0.05) ;MoCA score of severe OSAHS group (25.42±2.76) was significantly prolonged (F =3.954,P ＜0.01) than that of the normal control group (27.41±1.80).The MoCA analysis showed that memory/delayed recall score of the severe group (2.81 ± 0.98) was significantly decreased than the normal control group (4.06 ± 0.97,Z =13.075,P ＜0.01).The HAMA scores of the moderate and severe group were significantly higher than the normal group (F =3.576,P ＜0.05).The HAMD scores of the severe group were also significantly higher than the normal group (F =3.487,P ＜0.05).Correlation analysis showed that Fz,Cz,Pz,C3,C4,P300 latency and MoCA score was negatively correlated (r =-0.422,-0.410,-0.374,-0.424,-0.442,P ＜0.01) ;Fz P300 amplitude was negatively related to MoCA score (r =-0.346,P =0.013),ESS score and sleep apnea hypopnea index (AHI),the longest apnea time were positively correlated (r =0.409,0.342,P ＜ 0.05),and the average finger pulse oximetry (MSPO2) were negatively correlated (r =-0.342,P =0.041),memory/delayed recall and the minimum SPO2 (LSPO2) were positively correlated (r =0.355,P =0.041).Pz P300 latency and Fz P300 amplitude had significant influence on the MoCA.Conclusions ①Moderate to severe OSAHS patients existing MCI;②There was anxiety in moderate to severe OSAHS patients,depression in severe ones;③P300 detection can be used as electric physiological indicator of the evaluation of cognitive dysfunction in OSAHS patients,early detection of OSAHS in patients with cognitive dysfunction,combined with the MoCA score may provide the basis for early clinical intervention.
