本文選題：失眠障礙　切入點(diǎn)：記憶　出處：《安徽醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：背景:失眠是指盡管有適當(dāng)?shù)臋C(jī)會和環(huán)境睡眠,依然有睡眠起始、持續(xù)時間、鞏固或質(zhì)量的持續(xù)困難產(chǎn)生,并導(dǎo)致某種形式的日間損害。這些損害包括社交、職業(yè)、教育、學(xué)習(xí)、行為以及其他重要功能域,其中學(xué)習(xí)記憶能力的下降是失眠患者主觀功能受損最為常見主訴。近年來的研究表明失眠患者也存在客觀記憶損害,但這些損害是否具有亞型間的差異,以及是否涉及主/客觀睡眠參數(shù)的改變均沒有得到探索。目的:探索失眠障礙患者不同亞型(入睡困難、早醒、維持困難、混合型)間記憶和主/客觀睡眠參數(shù)有無差異及其相關(guān)性。方法:收集失眠障礙(insomnia disorder,ID)患者,采集一般信息(性別、年齡、教育程度),進(jìn)行情緒狀態(tài)、主觀睡眠質(zhì)量和總體認(rèn)知功能評價,包括:漢密爾頓抑郁量表17項(xiàng)版(HAMD-17)、匹茲堡睡眠質(zhì)量指數(shù)(PSQI)和蒙特利爾認(rèn)知評估量表(Mo CA,北京版)。當(dāng)晚完成多導(dǎo)睡眠監(jiān)測,次晨行睡眠自評,按自評結(jié)果將患者分為入睡困難型、早醒型、維持困難型和混合型4組。采用九盒迷宮試驗(yàn)檢測客觀記憶,包括參考、工作、物體、空間記憶。結(jié)果:①背景資料:各組間性別、年齡、病程、教育程度以及PSQI、HAMD-17和Mo CA分均無統(tǒng)計(jì)學(xué)差異(Ps0.05)。②記憶:4型患者的工作記憶和空間記憶錯誤數(shù)差異顯著(Ps0.05),即早醒和混合組的空間記憶和工作記憶差于維持難組(Ps0.05);參考記憶和物體記憶錯誤數(shù)均無組間差異(Ps0.05)。③主觀睡眠:4型患者PSQI分及其因子分均無組間差異(Ps0.05)。④客觀睡眠參數(shù):4型間睡眠效率和REM睡眠時間及REM%有顯著差異(Ps0.05),即混合組睡眠效率低于早醒和維持困難組(Ps0.05),早醒和混合組REM時間及REM%低于維持難組(Ps0.05)。⑤記憶與主/客觀睡眠參數(shù)的相關(guān)分析:控制性別、年齡和受教育年限后,記憶錯誤數(shù)與PSQI總分及各因子分Partial相關(guān)分析無顯著相關(guān)性(Ps0.05);工作記憶和空間記憶錯誤數(shù)與REM時間(r=-0.387、-0.348,Ps0.05)和REM%(r=-0.350、-0.354,Ps0.05)負(fù)相關(guān)。結(jié)論:ID各亞型患者間空間和工作記憶能力不同(早醒型和混合型最差);各亞型間PSQI睡眠質(zhì)量自評無明顯差異,但多導(dǎo)睡眠圖(PSG)客觀睡眠參數(shù)有細(xì)微差異。REM睡眠減少可能涉及記憶的損害。
[Abstract]:Background: insomnia refers to persistent difficulties with sleep initiation, duration, consolidation or quality, despite appropriate opportunities and environments for sleep, and leading to some form of daytime damage. These include social, professional, educational, Learning, behavior, and other important functional domains, in which the decline of learning and memory ability is the most common complaints of insomnia patients with impaired subjective function. Recent studies have shown that insomnia patients also have objective memory impairment. But whether these lesions have subtype differences and whether they involve changes in subjective / objective sleep parameters have not been explored. Objective: to explore the different subtypes of insomnia patients (difficulty in falling asleep, early waking up, difficulty in maintaining sleep). Methods: the patients with insomnia disorder were collected and general information (sex, age, education level) was collected for emotional state. Subjective sleep quality and overall cognitive function were evaluated, including Hamilton Depression scale (Hamd 17), Pittsburgh Sleep quality Index (PSQI), Montreal Cognitive Assessment scale (Montreal Cognitive Assessment scale), Beijing version. Polysomnography was completed that night and sleep self-assessment was performed in the morning. According to the self-evaluation results, the patients were divided into 4 groups: difficult to fall asleep, early awake, difficult to maintain and mixed. Objective memory, including reference, work, object and spatial memory, was tested by nine boxes maze test. Age, course of disease, There was no significant difference in educational level and scores of PSQI HAMD-17 and Mo CA. There were significant differences in the number of working memory and spatial memory errors between Ps0.05- 2 and memory type 4, i.e., the spatial memory and working memory of early waking and mixed group were worse than those of difficult maintenance group. There was no significant difference in the number of memory errors between groups. There was no significant difference in PSQI scores and their factor scores in patients with subjective sleep: 4 type 4. There were significant differences in sleep efficiency, sleep time and REM% among objective sleep parameters of Ps0.054.There were significant differences in sleep efficiency, sleep time and REM% in patients with subjective sleep type 4, that is, sleep in mixed group. The sleeping efficiency was lower than that in the early waking and maintenance difficulty groups (P < 0.05), and the REM time and REM% in the early waking and mixed groups were lower than those in the difficult maintenance group. The correlation analysis between memory and subjective / objective sleep parameters: controlling sex, After age and years of schooling, There was no significant correlation between the number of memory errors and the total score of PSQI and the Partial correlation analysis of each factor score. There was no significant correlation between the number of memory errors in working memory and spatial memory, but the number of errors in working memory and spatial memory were negatively correlated with REM time and REM time. Conclusion the spatial and working memory abilities of the patients with different subtypes of PSQI are different (P < 0.05). There was no significant difference in PSQI sleep quality among the subtypes. But the objective sleep parameters of PSG were slightly different. REM sleep loss may involve memory impairment.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R740

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相關(guān)期刊論文 前2條

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本文編號：1578151