山东大学耳鼻喉眼学报
山東大學耳鼻喉眼學報
산동대학이비후안학보
JOURNAL OF OTOLARYNGOLOGY AND OPHTHALMOLOGY OF SHANDONG UNIVERSITY
2015年
2期
1-8
,共8页
阿尔茨海默病%睡眠障碍%日间嗜睡%匹斯堡睡眠质量指数%艾泼沃兹日间嗜睡量表
阿爾茨海默病%睡眠障礙%日間嗜睡%匹斯堡睡眠質量指數%艾潑沃玆日間嗜睡量錶
아이자해묵병%수면장애%일간기수%필사보수면질량지수%애발옥자일간기수량표
Alzheimers disease%Sleep disorder%Daytime sleepiness%Pittsburgh sleep quality index%Epworth sleepi-ness scale
目的：分析阿尔茨海默病（A D）患者睡眠障碍的临床特点，探讨其与认知、精神行为、生活能力及护理负担的关系。方法收集山东省立医院神经内科就诊的阿尔茨海默病33例患者病历资料，采用简易精神状态评价量表（MMSE）等评估认知功能、精神症状和生活能力，采用匹斯堡睡眠质量指数（PSQI）和艾泼沃兹嗜睡量表（ESS）进行评估，将各量表得分进行相关分析。根据 PSQI 得分将患者分组，比较有无睡眠障碍的两组患者各量表得分情况。结果PSQI 量表中各类型的睡眠障碍在 A D患者中均有发生，发生率最高的依次为睡眠干扰（57．6％）、睡眠效率减低（54．5％）、日间功能障碍（51．5％）。PSQI 得分与 MMSE 得分呈负相关，与 C DR 得分呈正相关。A D患者睡眠质量、入睡困难、睡眠时间、睡眠效率得分与 MMSE 得分呈负相关。定向力、即刻记忆、绘图等与 PSQI 得分呈负相关。A D患者中有睡眠障碍的较无睡眠障碍的 C DR 得分高，MMSE 得分低。精神症状中，妄想、情感淡漠、食欲／进食障碍与睡眠障碍有相关性。有睡眠障碍的日常生活能力量表、护理负担量表得分高于无睡眠障碍患者。结论A D患者普遍出现各种类型的睡眠障碍，此类患者的睡眠障碍与其痴呆程度、认知功能、日常生活能力、精神症状等密切相关，相对应的护理负担加重。
目的：分析阿爾茨海默病（A D）患者睡眠障礙的臨床特點，探討其與認知、精神行為、生活能力及護理負擔的關繫。方法收集山東省立醫院神經內科就診的阿爾茨海默病33例患者病歷資料，採用簡易精神狀態評價量錶（MMSE）等評估認知功能、精神癥狀和生活能力，採用匹斯堡睡眠質量指數（PSQI）和艾潑沃玆嗜睡量錶（ESS）進行評估，將各量錶得分進行相關分析。根據 PSQI 得分將患者分組，比較有無睡眠障礙的兩組患者各量錶得分情況。結果PSQI 量錶中各類型的睡眠障礙在 A D患者中均有髮生，髮生率最高的依次為睡眠榦擾（57．6％）、睡眠效率減低（54．5％）、日間功能障礙（51．5％）。PSQI 得分與 MMSE 得分呈負相關，與 C DR 得分呈正相關。A D患者睡眠質量、入睡睏難、睡眠時間、睡眠效率得分與 MMSE 得分呈負相關。定嚮力、即刻記憶、繪圖等與 PSQI 得分呈負相關。A D患者中有睡眠障礙的較無睡眠障礙的 C DR 得分高，MMSE 得分低。精神癥狀中，妄想、情感淡漠、食欲／進食障礙與睡眠障礙有相關性。有睡眠障礙的日常生活能力量錶、護理負擔量錶得分高于無睡眠障礙患者。結論A D患者普遍齣現各種類型的睡眠障礙，此類患者的睡眠障礙與其癡呆程度、認知功能、日常生活能力、精神癥狀等密切相關，相對應的護理負擔加重。
목적：분석아이자해묵병（A D）환자수면장애적림상특점，탐토기여인지、정신행위、생활능력급호리부담적관계。방법수집산동성립의원신경내과취진적아이자해묵병33례환자병력자료，채용간역정신상태평개량표（MMSE）등평고인지공능、정신증상화생활능력，채용필사보수면질량지수（PSQI）화애발옥자기수량표（ESS）진행평고，장각량표득분진행상관분석。근거 PSQI 득분장환자분조，비교유무수면장애적량조환자각량표득분정황。결과PSQI 량표중각류형적수면장애재 A D환자중균유발생，발생솔최고적의차위수면간우（57．6％）、수면효솔감저（54．5％）、일간공능장애（51．5％）。PSQI 득분여 MMSE 득분정부상관，여 C DR 득분정정상관。A D환자수면질량、입수곤난、수면시간、수면효솔득분여 MMSE 득분정부상관。정향력、즉각기억、회도등여 PSQI 득분정부상관。A D환자중유수면장애적교무수면장애적 C DR 득분고，MMSE 득분저。정신증상중，망상、정감담막、식욕／진식장애여수면장애유상관성。유수면장애적일상생활능역량표、호리부담량표득분고우무수면장애환자。결론A D환자보편출현각충류형적수면장애，차류환자적수면장애여기치태정도、인지공능、일상생활능력、정신증상등밀절상관，상대응적호리부담가중。
Objective To describe the characteristic of sleep disorders in patients with Alzheimers disease and discuss the relationships between sleep disorder and cognitive function,psychiatric symptoms,living abilities and the caregiver burden.Methods 33 patients with Alzheimers disease were recruited from clinics of Shandong Provincial Hospital. MMSE was used to measure the cognitive function and the degree of dementia.PSQI and ESS were used to evaluate the sleep disorders of the patients.The data were analyzed with software SPSS version 21.0.Results All items in PSQI occured in A Dpatients.The most common symptoms were sleep disturbance (57.6%),followed by reduction of sleep efficiency (54.5%)and daytime dysfunction (51.5%),most of which were of mild impairment.The least common i-tem is the using of hypnotic drugs (9.1%).In PSQI,the sleep quality,difficulty falling asleep,sleep time,sleep effi-ciency were negatively related to MMSE score.In MMSE,orientation,immediate memory,drawing were negatively related to PSQI score.NPI and CS DDscores were both possitively related to PSQI score.Delusion,apathy,sleep/be-havior at night and depression were more related to sleep disorders.Patients with sleep disorders had higher A DL and ZBI scores than patients without sleep disorder.Conclusion Various kinds of sleep disorders can occur in the process of Alzheimers disease.The sleep disorders are closely related to the degree of dementia,cognitive function,living abil-ity and psychiatric symptoms.Also,sleep disorders aggravate the patientscaregiver burden.
