原发性失眠症患者认知功能与生活质量的研究

发布时间：2018-05-11 02:44

本文选题：原发性失眠症 + 认知功能　；参考：《苏州大学》2015年硕士论文

【摘要】：目的:(1)探讨原发性失眠症患者认知功能损害的特点及影响因素,为失眠症患者认知功能的神经心理学研究提供一定的理论依据。(2)探讨原发性失眠症患者的生活质量及相关影响因素,为改善失眠患者的生活质量提供一定的科学依据。方法:(1)采用神经心理测验包括韦氏记忆(数字累加、视觉再认、视觉再生、联想学习)、数字广度、数字化消、连线测验TMT、威斯康辛卡片分类测验(WCST)分别对46例原发性失眠症患者(PI组)及40名健康对照者(HC组)进行注意力、记忆力、执行功能等方面的测评;(2)采用世界卫生组织生活质量评估量表(WHOQOL)分别对50例原发性失眠症患者和40名健康对照组进行生活质量(QOL)的评估;(3)应用匹兹堡睡眠质量指数量表(PSQI)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评定原发性失眠症患者的病情及焦虑抑郁程度。结果:(1)原发性失眠症患者的认知功能损害特点及影响因素:?PI组在数字累加、视觉再认、视觉再生、联想学习、数字倒背、注意力失误率、连线测验B及B-A完成时间和威斯康辛卡片测验各项成绩(正确应答数除外)均低于HC组。?PI组患者SDS分与PSOI、SAS分成正相关;数字累加分与病程成负相关;联想学习分与PSQI成负相关;连线测验B及连线测验B-A的时间与病程成正相关;WCST持续错误百分比与SDS成正相关。(2)原发性失眠症患者的生活质量及影响因素:?PI组在生理领域、心理领域、独立性领域、社会关系领域、环境领域和总体生活质量中评分均低于HC组。?PI组重度失眠组总体生活质量低于中度失眠组,焦虑抑郁共存组的总体生活质量低于无焦虑抑郁组。?在相关分析中,SAS分与各领域(精神支柱领域除外)和总体生活质量成负相关;SDS分与各领域和总体生活质量成负相关;PSQI分与生理领域、心理领域、独立性领域、精神支柱领域和总体生活质量成负相关。?在多元逐步回归分析中,SDS分、PSQI分、家族史等3个自变量成为影响患者生活质量总分的主要因素。结论:(1)原发性失眠症患者存在记忆力、注意力、执行功能等认知功能的损害。(2)病程的长短,病情的严重程度以及伴发的焦虑抑郁情绪是导致认知功能损害的相关影响因素。(3)原发性失眠症患者的生活质量在生理、心理、独立性、社会关系、环境等维度和总体生活质量都有显著降低。(4)失眠所伴随的焦虑抑郁情绪,失眠的严重程度和有无家族史是影响原发性失眠症患者生活质量的主要因素。
[Abstract]:Objective to explore the characteristics and influencing factors of cognitive impairment in patients with primary insomnia. To provide a certain theoretical basis for neuropsychological research on cognitive function of patients with insomnia. (2) to explore the quality of life of patients with primary insomnia and related influencing factors, and to provide a scientific basis for improving the quality of life of patients with insomnia. Methods the neuropsychological test included Wechsler's memory (digital accumulation, visual recognition, visual regeneration, associative learning, digital span, digital elimination). Wired test (TMT), Wisconsin card sorting test (WCST) for 46 patients with primary insomnia (Pi group) and 40 healthy controls (group HC) for attention and memory, Quality of life (QOL) of 50 patients with primary insomnia and 40 healthy controls were evaluated by the World Health Organization quality of Life Assessment scale (WHOQOL) and the Pittsburgh Sleep quality Index (Pittsburgh Sleep quality Index) was used to evaluate the quality of life of 50 patients with primary insomnia and 40 healthy controls. PSQI, SDS and SAS were used to evaluate the condition and degree of anxiety and depression in patients with primary insomnia. Results the cognitive impairment characteristics of patients with primary insomnia and their influencing factors: the accumulation of numbers, visual recognition, visual regeneration, associative learning, digital backside, and attention failure rate. The completion time of B and B-A and the scores of Wisconsin card test (except correct response) were lower than those of HC group and Pi group, the scores of SDS and PSOISAs were positively correlated, the cumulative scores of numbers were negatively correlated with the course of disease, the scores of associative learning were negatively correlated with PSQI. There was a positive correlation between the duration of WCST and the duration of disease course. The percentage of persistent errors in WCST was positively correlated with SDS. 2) the quality of life of patients with primary insomnia and its influencing factors were in physiological, psychological and independence fields. The scores of social relations, environmental field and total quality of life were lower than those of HC group. The total quality of life of severe insomnia group was lower than that of moderate insomnia group, and the overall quality of life of anxiety depression coexisting group was lower than that of non-anxiety depression group. In the correlation analysis, the scores of SAS were negatively correlated with the fields (except for the spiritual pillar) and the total quality of life. The SDS scores were negatively correlated with the fields and the overall quality of life. The scores of PSQI were negatively correlated with the physiological, psychological, and independent fields. Pillar area and overall quality of life negatively. In multivariate stepwise regression analysis, three independent variables, such as SDS score, PSQI score and family history, were the main factors affecting patients' total quality of life score. Conclusion (1) patients with primary insomnia have cognitive impairment, such as memory, attention, executive function, etc. The severity of the illness and the associated anxiety and depression are the related factors that lead to cognitive impairment. The quality of life of patients with primary insomnia is physiological, psychological, independent, social relations. The anxiety and depression associated with insomnia were significantly decreased in the dimensions of environment and overall quality of life. The severity of insomnia and the existence of family history were the main factors affecting the quality of life of patients with primary insomnia.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R740

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