CAJ | 학술논문

目的：评估REM型与NREM型阻塞性睡眠呼吸暂停综合征（OSAS）患者的认知功能受损情况。方法纳入206例拟诊为OSAS并行整夜多导睡眠图（PSG）检查的连续病例，检查前当晚进行简易智能量表评估、画钟测验、词语流畅性测验、数字广度测验等，根据PSG检查结果，将受试者分为单纯鼾症组和 OSAS 组，后者再分为 REM 型和 NREM 型，并对组间认知功能成绩进行比较。结果依照纳入、排除标准，最终纳入病例161例，其中单纯鼾症41例，OSAS患者120例，后者分为REM型36例，NREM型84例。与单纯鼾症组比较，OSAS组画钟测验、词语流畅性测验、数字广度测验（顺式、逆式）、连线测验（A、B ）、数字符号转换测验、警觉性测验成绩均较差，且差异有统计学意义（ P ＜0．05），而MMSE得分无明显差异（P ＞0．05）；REM 组连线测验[A ：（68．62±36．97）比（83．78±38.60），P＜0．05；B：（74．06±37．58）比（88．72±36．24），P＜0．05]、数字符号测验[（39．96±14．11）比（32．92±10．06），P ＜0．05]成绩较NREM组差，而数字广度测验（顺式）[（10．83±2．73）比（12．03±2．62），P＜0．05]成绩较NREM组好。结论相对于单纯鼾症患者而言，OSAS患者存在多方面的认知功能损害，表现为执行功能、词语流畅性、注意力、即时记忆力、视空间能力、一般学习能力、警觉性损害。REM型OSAS患者在视空间能力、一般学习能力方面损害较重；NREM型OSAS患者在注意力方面损害较重。
목적：평고REM형여NREM형조새성수면호흡잠정종합정（OSAS）환자적인지공능수손정황。방법납입206례의진위OSAS병행정야다도수면도（PSG）검사적련속병례，검사전당만진행간역지능량표평고、화종측험、사어류창성측험、수자엄도측험등，근거PSG검사결과，장수시자분위단순한증조화 OSAS 조，후자재분위 REM 형화 NREM 형，병대조간인지공능성적진행비교。결과의조납입、배제표준，최종납입병례161례，기중단순한증41례，OSAS환자120례，후자분위REM형36례，NREM형84례。여단순한증조비교，OSAS조화종측험、사어류창성측험、수자엄도측험（순식、역식）、련선측험（A、B ）、수자부호전환측험、경각성측험성적균교차，차차이유통계학의의（ P ＜0．05），이MMSE득분무명현차이（P ＞0．05）；REM 조련선측험[A ：（68．62±36．97）비（83．78±38.60），P＜0．05；B：（74．06±37．58）비（88．72±36．24），P＜0．05]、수자부호측험[（39．96±14．11）비（32．92±10．06），P ＜0．05]성적교NREM조차，이수자엄도측험（순식）[（10．83±2．73）비（12．03±2．62），P＜0．05]성적교NREM조호。결론상대우단순한증환자이언，OSAS환자존재다방면적인지공능손해，표현위집행공능、사어류창성、주의력、즉시기억력、시공간능력、일반학습능력、경각성손해。REM형OSAS환자재시공간능력、일반학습능력방면손해교중；NREM형OSAS환자재주의력방면손해교중。
Objective To evaluate cognitive impairment of REM -related obstructive sleep apnea syndrome (REM -OSAS) and NREM -related obstructive sleep apnea syndrome (NREM -OSAS) pa‐tients .Methods Totals of 206 consecutive suspected OSAS patients who underwent overnight polysom‐nogram were involved .On the night of undergoing PSG ,all the participants complete Mini -mental State Examination (MMSE) ,Clock Drawing Test (CDT ) ,Verbal Fluency Test (VFT ) ,Digit Span Test (DST) ,et al .All participants were classified as simple snoring group and OSAS group after over‐night polysomnogram .Then ,OSAS patients were classified as REM -OSAS and NREM -OSAS to compare the performance of cognition .Results According to inclusive and exclusive criterion ,161 pa‐tients were involved finally .There were simple snoring patients (n= 41) and OSAS patients (n= 120) which included REM -OSAS patients(n= 36)and NREM -OSAS patients (n = 84) .Compared with simple snoring group ,performance on CDT ,VFT ,DST (the order and reversal order) ,trail making test (A、B) ,symbol digit modalities test (SDMT) ,vigilance task (VT) were impaired significantly in OSAS group (P < 0 .05) .There was no significant difference between the two groups in the score of MMSE (P > 0 .05) .Compared with NREM -OSAS group ,the performance on TMT [A :(68 .62 ± 36.97) vs (83 .78 ± 38 .60);B:(74 .06 ± 37 .58) vs (88 .72 ± 36 .24)] ,SDMT[(39 .96 ± 14 .11) vs (32 .92 ± 10 .06)]were poor and the performance of DST[the order:(10 .83 ± 2 .73) vs (12 .03 ± 2 .62)]was good in the REM -OSAS group (P< 0 .05) .Conclusions Related to simple snoring patients ,OSAS patients have various cognitive impairment ,such as executive ,verbal fluency ,attention ,instant memory ,visual spatial function ,generally learning ability and vigilance .Visual spatial function and generally learning ability of REM -OSAS patients are impaired seriously;attention of NREM -OSAS patients is impaired seriously .