CAJ | 학술논문

目的研究OSAHS患者的注意网络及相关认知,探讨其可能的影响因素.方法经神经心理学测试筛查选取2013年6月至2014年3月在合肥市第一人民医院呼吸内科睡眠监测室多导睡眠监测确诊的OSAHS患者50例,其中男43例,女7例,年龄23 ～ 60岁,平均(43±10)岁,同期纳入40名健康对照者,其中男35名,女5名,年龄24～60岁,平均(44±10)岁,对所有患者进行注意网络测试并与对照组比较.结果 OSAHS组的执行控制网络时间[(138 ±58) ms]较对照组[(104±37)ms]明显延长,与对照组比较差异有统计学意义(P＜0.O1).OSAHS组在神经心理学背景测试MoCA评分(25.1±2.9)、stroop效应(16±11)、词汇流畅性(18±4)、数字广度测试(7.3±1.4、5.1±1.6)、HAMA焦虑(4.5±4.0)、贝克抑郁评分(4.8±3.3)与健康对照组相比较差,差异有统计学意义(均P＜0.05),而警觉、定向网络、反应时间及正确率两组差异均无统计学意义(均P ＞0.05).OSAHS组的执行网络与夜间最长呼吸暂停时间呈显著正相关(r =0.620,P＜0.01),与平均氧饱和度、最低氧饱和度呈负相关(r=-0.869,-0.577,均P＜0.05).结论 OSAHS患者存在一定程度的注意力缺损,以执行控制网络损伤尤为明显,夜间缺氧和通气不足可能是影响其注意力和执行功能的重要因素.
목적 연구OSAHS환자적주의망락급상관인지,탐토기가능적영향인소.방법 경신경심이학측시사사선취2013년6월지2014년3월재합비시제일인민의원호흡내과수면감측실다도수면감측학진적OSAHS환자50례,기중남43례,녀7례,년령23 ～ 60세,평균(43±10)세,동기납입40명건강대조자,기중남35명,녀5명,년령24～60세,평균(44±10)세,대소유환자진행주의망락측시병여대조조비교.결과 OSAHS조적집행공제망락시간[(138 ±58) ms]교대조조[(104±37)ms]명현연장,여대조조비교차이유통계학의의(P＜0.O1).OSAHS조재신경심이학배경측시MoCA평분(25.1±2.9)、stroop효응(16±11)、사회류창성(18±4)、수자엄도측시(7.3±1.4、5.1±1.6)、HAMA초필(4.5±4.0)、패극억욱평분(4.8±3.3)여건강대조조상비교차,차이유통계학의의(균P＜0.05),이경각、정향망락、반응시간급정학솔량조차이균무통계학의의(균P ＞0.05).OSAHS조적집행망락여야간최장호흡잠정시간정현저정상관(r =0.620,P＜0.01),여평균양포화도、최저양포화도정부상관(r=-0.869,-0.577,균P＜0.05).결론 OSAHS환자존재일정정도적주의력결손,이집행공제망락손상우위명현,야간결양화통기불족가능시영향기주의력화집행공능적중요인소.
Objective To explore the different aspects of attention function in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and further to investigate the factors related to the impairments.Methods After one night polysomnography (PSG) monitoring,a total of 50 patients with OSAHS and 40 demographic-matched healthy controls received basic cognitive assessment with a neuropsychological battery and then performed the attention networks test (ANT) was performed.Results Compared with healthy controls,patients with OSAHS performed significantly worse on cognitive tests and emotion evaluation including Montreal Cognitive Assessment (MoCA),stroop,verbal fluency,digital span,Hamilton anxiety scale (HAMA) and Beck depression inventory (BDI).With regard to ANT,significant group differences were found in executive control network [(138 ± 58) ms vs (104 ± 37) ms,P =0.003],but not in alertness [(33 ±36)ms vs (33 ± 18)ms,P =0.975] or orientation [(48 ±30)ms vs (51 ±22) ms,P =0.674].Correlation analysis indicated that the scores of the executive control network was positively correlated with the longest apnea time during the night (r =0.620,P =0.006),but was negatively correlated with the average oxygen saturation(r =-0.869,P =0.000) and the lowest oxygen saturation(r =-0.577,P =0.019).Conclusions Patients with OSAHS were associated with impaired attention function,especially in the executive control network efficiency.Chronic hypoxia and apnea during the sleep may be the key factors that could diminish their attention and executive function.