血管性认知功能障碍患者睡眠结构特征分析

发布时间：2018-04-08 22:21

本文选题：血管性认知功能障碍　切入点：多导睡眠监测　出处：《新疆医科大学》2017年硕士论文

【摘要】：目的:了解VCI患者的睡眠结构特点及其与认知受损严重程度的关系。方法:连续收集2015年1月至2017年1月在新疆医科大学第六附属医院神经内科住院及门诊的VCI患者,以符合入选及排除标准的VCI患者50例为研究对象,另选取50例老年体检且为非认知障碍者作对照。认知障碍组与非认知障碍组的年龄、性别、受教育程度、体重指数、高血压病史、糖尿病病史、吸烟史比较差异均无统计学意义(P0.05)。两组均进行睡眠监测(晚10点至第二天早6点,总计8小时)。结果:(1)与非认知障碍组比较,有认知障碍的VCI组主观睡眠质量差,日间功能差。匹兹堡睡眠量表(PSQI)评分认知障碍VCI组和非认知障碍组总分分别为16.18±2.17和9.02±1.20(P0.05),爱泼沃斯睡眠量表(ESS)评分分别为10.66±2.00和6.54±1.63(P0.05)。(2)睡眠结构分析:与非认知障碍组相比,有认知障碍的VCI组总睡眠时间(TST)、睡眠效率(SE)、2期睡眠时间(TS2)、3-4期睡眠时间(TS3-4)、S3-4/TST(%)、REM睡眠时间(TREMS)、REM/TST(%)均减少(P0.05)。睡眠潜伏期(SL)、觉醒次数(AN)、睡眠觉醒时间(WASO)、1期睡眠时间(TS1)、S1/TST(%)均增多(P0.05)。(3)根据MMSE评分和CDR评分将有认知障碍的VCI组患者分成VCIND组、轻度VCI组、中度VCI组三个亚组,三个亚组间的睡眠结构分析结果示:与VCIND组相比,轻度VCI组与中度VCI组总睡眠时间(TST)、睡眠效率(SE)、2期睡眠时间(TS2)、3-4期睡眠时间(TS3-4)、S3-4/TST(%)、REM睡眠时间(TREMS)、REM/TST(%)均减少(P0.05)。睡眠潜伏期(SL)、觉醒次数(AN)、睡眠觉醒时间(WASO)、1期睡眠时间(TS1)、S1/TST(%)均增多(P0.05)。(4)VCI组三个亚组的MMSE评分、CDR评分与睡眠结构的相关性分析显示:S1/TST(%)与MMSE评分呈负相关(P0.05),S3-4/TST(%)、REM/TST(%)与MMSE评分呈正相关(P0.05)。S1/TST(%)与CDR评分呈正相关(P0.05),S3-4/TST(%)、REM/TST(%)与CDR评分呈负相关(P0.05)。结论:VCI患者存在睡眠障碍、睡眠结构紊乱,且与患者的认知受损程度存在相关性。
[Abstract]:Objective: to investigate the characteristics of sleep structure and its relationship with the severity of cognitive impairment in patients with VCI.Methods: VCI patients were collected from January 2015 to January 2017 in Department of Neurology, sixth affiliated Hospital of Xinjiang Medical University. 50 VCI patients who met the criteria of inclusion and exclusion were studied.In addition, 50 elderly patients with non-cognitive impairment were selected as control group.There were no significant differences in age, sex, education level, body mass index, hypertension history, diabetes history and smoking history between the cognitive impairment group and the non-cognitive disorder group (P 0.05).Sleep monitoring was performed in both groups (10:00 to 6am on the second day, for a total of 8 hours.Results compared with the control group, the VCI group with cognitive impairment had poor subjective sleep quality and poor daytime function.In the VCI group with cognitive impairment, the total sleep time and sleep efficiency during the second phase of sleep and the sleep time of TS3-4 / S3-4 / TST were significantly decreased (P < 0.05).There was a positive correlation between P0.05 / TSTT score and CDR score (P 0.05 / TSTT score). There was a negative correlation between P0.05 / TSTT score and CDR score and a negative correlation between P0.05 / TSTR score and REM / TSTR score (P 0.05).Conclusion there are sleep disorders and sleep structure disorders in patients with VCI, and there is a correlation between sleep disorder and cognitive impairment in patients with VCI.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.13

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