中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2014年
5期
341-344
,共4页
阻塞性睡眠呼吸暂停低通气综合征%事件相关电位%认知功能
阻塞性睡眠呼吸暫停低通氣綜閤徵%事件相關電位%認知功能
조새성수면호흡잠정저통기종합정%사건상관전위%인지공능
Obstructive sleep apnea hypopnea syndrome%Event-related potential%Cognitive function
目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者事件相关电位(ERP) P300的特点及其影响因素.方法 选取OSAHS患者22例(病例组)和健康正常人18例(对照组)为研究对象,分别进行P300测定,采用相关性分析和逐步多元回归分析法对OSAHS患者睡眠模式、睡眠呼吸暂停低通气指数(AHI)、平均血氧饱和度(MSaO2)、最低血氧饱和度(LSaO2)、非快速眼动(NREM)睡眠第Ⅰ、Ⅱ、Ⅲ、Ⅳ期和快速眼动(REM)睡眠占总睡眠时间的百分比、氧饱和度低于90％的睡眠时间(90％ SaO2)等指标与P300潜伏期和波幅间的关系进行探讨.结果 病例组P300中P3波的潜伏期[(344.24±23.99) ms]大于对照组P3波的潜伏期[(311.17±15.65) ms] (P＜ 0.05),其P3波的波幅[(3.66±1.49)μV]低于对照组P3波的波幅[(6.26±1.48) μV] (P ＜0.05).P3波潜伏期与NREMⅠ+Ⅱ占总睡眠时间的百分比(r=0.492,P＜0.05)、90％SaO2(r=0.627,P＜0.01)、AHI(r=0.882,P＜0.01)呈正相关,与NREMⅢ+Ⅳ占总睡眠时间的百分比(r=-0.558,P＜0.01)、LSaO2(r=-0.479,P＜0.05)、MSaO2(r=-0.519,P＜0.05)呈负相关.P3波的波幅与NREMⅠ+Ⅱ占总睡眠时间的百分比(r=-0.491,P ＜0.05)、90％ SaO2(r=-0.626,P ＜0.01)、AHI(r=-0.866,P＜0.01)呈负相关,与NREMⅢ+Ⅳ占总睡眠时间的百分比(r=0.516,P ＜0.05)、LSaO2(r=0.475,P ＜0.05)、MSaO2(r=0.514,P ＜0.05)呈正相关.经过多元线性回归分析后,发现AHI对P300的影响较大.结论 OSAHS患者P300存在异常,其变化与OSAHS患者的病情严重程度具有相关性,其中AHI对P300的影响较大.
目的 探討阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者事件相關電位(ERP) P300的特點及其影響因素.方法 選取OSAHS患者22例(病例組)和健康正常人18例(對照組)為研究對象,分彆進行P300測定,採用相關性分析和逐步多元迴歸分析法對OSAHS患者睡眠模式、睡眠呼吸暫停低通氣指數(AHI)、平均血氧飽和度(MSaO2)、最低血氧飽和度(LSaO2)、非快速眼動(NREM)睡眠第Ⅰ、Ⅱ、Ⅲ、Ⅳ期和快速眼動(REM)睡眠佔總睡眠時間的百分比、氧飽和度低于90％的睡眠時間(90％ SaO2)等指標與P300潛伏期和波幅間的關繫進行探討.結果 病例組P300中P3波的潛伏期[(344.24±23.99) ms]大于對照組P3波的潛伏期[(311.17±15.65) ms] (P＜ 0.05),其P3波的波幅[(3.66±1.49)μV]低于對照組P3波的波幅[(6.26±1.48) μV] (P ＜0.05).P3波潛伏期與NREMⅠ+Ⅱ佔總睡眠時間的百分比(r=0.492,P＜0.05)、90％SaO2(r=0.627,P＜0.01)、AHI(r=0.882,P＜0.01)呈正相關,與NREMⅢ+Ⅳ佔總睡眠時間的百分比(r=-0.558,P＜0.01)、LSaO2(r=-0.479,P＜0.05)、MSaO2(r=-0.519,P＜0.05)呈負相關.P3波的波幅與NREMⅠ+Ⅱ佔總睡眠時間的百分比(r=-0.491,P ＜0.05)、90％ SaO2(r=-0.626,P ＜0.01)、AHI(r=-0.866,P＜0.01)呈負相關,與NREMⅢ+Ⅳ佔總睡眠時間的百分比(r=0.516,P ＜0.05)、LSaO2(r=0.475,P ＜0.05)、MSaO2(r=0.514,P ＜0.05)呈正相關.經過多元線性迴歸分析後,髮現AHI對P300的影響較大.結論 OSAHS患者P300存在異常,其變化與OSAHS患者的病情嚴重程度具有相關性,其中AHI對P300的影響較大.
목적 탐토조새성수면호흡잠정저통기종합정(OSAHS)환자사건상관전위(ERP) P300적특점급기영향인소.방법 선취OSAHS환자22례(병례조)화건강정상인18례(대조조)위연구대상,분별진행P300측정,채용상관성분석화축보다원회귀분석법대OSAHS환자수면모식、수면호흡잠정저통기지수(AHI)、평균혈양포화도(MSaO2)、최저혈양포화도(LSaO2)、비쾌속안동(NREM)수면제Ⅰ、Ⅱ、Ⅲ、Ⅳ기화쾌속안동(REM)수면점총수면시간적백분비、양포화도저우90％적수면시간(90％ SaO2)등지표여P300잠복기화파폭간적관계진행탐토.결과 병례조P300중P3파적잠복기[(344.24±23.99) ms]대우대조조P3파적잠복기[(311.17±15.65) ms] (P＜ 0.05),기P3파적파폭[(3.66±1.49)μV]저우대조조P3파적파폭[(6.26±1.48) μV] (P ＜0.05).P3파잠복기여NREMⅠ+Ⅱ점총수면시간적백분비(r=0.492,P＜0.05)、90％SaO2(r=0.627,P＜0.01)、AHI(r=0.882,P＜0.01)정정상관,여NREMⅢ+Ⅳ점총수면시간적백분비(r=-0.558,P＜0.01)、LSaO2(r=-0.479,P＜0.05)、MSaO2(r=-0.519,P＜0.05)정부상관.P3파적파폭여NREMⅠ+Ⅱ점총수면시간적백분비(r=-0.491,P ＜0.05)、90％ SaO2(r=-0.626,P ＜0.01)、AHI(r=-0.866,P＜0.01)정부상관,여NREMⅢ+Ⅳ점총수면시간적백분비(r=0.516,P ＜0.05)、LSaO2(r=0.475,P ＜0.05)、MSaO2(r=0.514,P ＜0.05)정정상관.경과다원선성회귀분석후,발현AHI대P300적영향교대.결론 OSAHS환자P300존재이상,기변화여OSAHS환자적병정엄중정도구유상관성,기중AHI대P300적영향교대.
Objective To study the characteristics and influencing factors of event-related potential (ERP) P300 in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Twenty-two OSAHS patients (OSAHS group) and 18 healthy subjects (control group) were recruited,and the ERP P300 was recorded with all the subjects.The correlation between latency and amplitude of P300 and influencing factors including variation of sleep mode,apnea hypopnea index (AHI),mean oxyhemoglobin saturation level(MSaO2),the lowest of oxyhemoglobin saturation level (LSaO2),time of non-rapid eye movement (NREM) sleep Ⅰ,Ⅱ,Ⅲ,Ⅳ stage and rapid eye movement (REM) sleep over total sleep time and total sleep time of SaO2 ＜ 90％ (90％ SaO2) were analyzed by using linear regression correlation analysis and multiple stepwise regression analysis.Results The latencies of P3 component of P300 in OSAHS group were longer than that of control group[(344.24 ± 23.99)ms versus (311.17 ± 15.65) ms] (P＜ 0.05),while the amplitudes were decreased and lower in OSAHS group than that in control group [(3.66 ± 1.49) μV versus (6.26 ± 1.48) μV] (P ＜ 0.05).There revealed positive correlations between P3 latency and NREM Ⅰ and Ⅱ (r=0.492,P＜0.05),90％SaO2(r=0.627,P＜0.01),AHI(r=0.882,P＜0.01); negative correlation between P3 latency and NREM Ⅲ and Ⅳ (r =-0.558,P ＜ 0.01),LSaO2,(r =-0.479,P ＜0.05),MSaO2 (r =-0.519,P ＜ 0.05) was shown.There also revealed negative correlation between P3 amplitude and NREM Ⅰ and Ⅱ (r=-0.491,P ＜0.05),90％SaO2(r =-0.626,P＜0.01),AHI(r =-0.866,P ＜0.01),and positive correlation between P3 amplitude and NREM Ⅲ and Ⅳ (r =0.516,P ＜ 0.05),LSaO2 (r =0.475,P ＜ 0.05) 、MSaO2 (r =0.514,P ＜ 0.05).Stepwise regression and multivariate analysis revealed that AHI was one of the most significant influencing factors for latency and amplitude of P300 (P ＜ 0.01).Conclusion The OSAHS patients have cognitive dysfunction as reflected by the abnormalities of event-related potential P300 and the scale of its changes are correlated with the severity of OSAHS.The AHI is the most influential factor of P300.
