CPAP与SOA治疗OSAHS患者认知功能障碍的疗效比较

发布时间：2018-12-12 12:33

【摘要】：目的比较合并认知功能障碍的中度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者使用经鼻持续正压通气(continuous positive airway pressure,CPAP)或者自行调节式口腔矫治器(Self-adjusting Oral Appliance,SOA)治疗后的疗效。方法经蒙特利尔认知评估量表(Montreal Cognitive Assessment,MOCA)评估和多导睡眠监测(polysomnography,PSG)监测及纳入、排除标准筛选出的56例合并认知功能障碍的中度OSAHS患者,随机分为两组,分别使用SOA治疗或CPAP治疗,并采用MOCA和PSG于治疗前一周以及治疗3个月后对患者行认知功能检查和PSG监测。对所获各项观察指标的数据进行统计学分析,以P0.05为差异有统计学意义。结果两组中度OSAHS患者睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度(lowest blood oxygen saturation,LSa O2)和MOCA评分在治疗前1周及治疗3个月后的差异有统计学意义(P0.01);两治疗组治疗前后MOCA各项评分中注意力项和记忆项得分差异有统计学意义(P0.01);视空间/执行功能项和抽象能力项SOA组得分差异有统计学意义(P0.01),CPAP组差异有统计学意义(P0.05);两组的命名项、语言项和定向力项没有差异(P0.05)。两治疗组治疗后睡眠呼吸参数、MOCA总分及各项评分差异无统计学意义(P0.05)。结论 CPAP与SOA治疗有认知功能障碍中度OSAHS患者的客观疗效相当,都是治疗有认知功能障碍中度OSAHS患者的有效方法;二者在治疗合并认知功能障碍的中度OSAHS患者时,对于认知功能的恢复有效且程度相当,在临床皆可作为合并认知功能障碍中度OSAHS患者的治疗方式。
[Abstract]:Objective to compare the patients with moderate obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea-hypopnea syndrome,OSAHS) with cognitive impairment by nasal continuous positive pressure ventilation (continuous positive airway pressure,). CPAP) or self-adjusting oral appliance (Self-adjusting Oral Appliance,SOA) after treatment. Methods 56 patients with moderate OSAHS with cognitive impairment were assessed by Montreal Cognitive Assessment scale (Montreal Cognitive Assessment,MOCA) and polysomnography (polysomnography,PSG). The patients were randomly divided into two groups. The patients were treated with SOA or CPAP respectively. The cognitive function and PSG were monitored by MOCA and PSG one week before treatment and 3 months after treatment. The data of each observation index were analyzed statistically, and the difference was statistically significant with P0.05. Results there were significant differences between the two groups in sleep apnea hypopnea index (apnea hypopnea index,AHI), minimum oxygen saturation (lowest blood oxygen saturation,LSa O 2) and MOCA scores 1 week before treatment and 3 months after treatment (P0.01). There were significant differences in the scores of attention item and memory item between the two groups before and after treatment (P0.01). Visual space / executive function item and abstract ability item SOA group score difference was statistically significant (P0.01), CPAP group difference was statistically significant (P0.05), the two groups of naming items, language items and orientational ability items have no difference (P0.05). There was no significant difference in sleep breathing parameters, total MOCA score and scores between the two groups after treatment (P0.05). Conclusion the objective efficacy of CPAP and SOA in the treatment of moderate OSAHS patients with cognitive impairment is comparable, and it is an effective method to treat moderate OSAHS patients with cognitive dysfunction. In the treatment of moderate OSAHS patients with cognitive impairment, both of them are effective and equal in the recovery of cognitive function, and can be used as treatment methods in patients with moderate OSAHS with cognitive dysfunction.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766

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