發(fā)布時間：2018-12-12 12:33

【摘要】：目的 比較合并認(rèn)知功能障礙的中度阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者使用經(jīng)鼻持續(xù)正壓通氣(continuous positive airway pressure,CPAP)或者自行調(diào)節(jié)式口腔矯治器(Self-adjusting Oral Appliance,SOA)治療后的療效。方法 經(jīng)蒙特利爾認(rèn)知評估量表(Montreal Cognitive Assessment,MOCA)評估和多導(dǎo)睡眠監(jiān)測(polysomnography,PSG)監(jiān)測及納入、排除標(biāo)準(zhǔn)篩選出的56例合并認(rèn)知功能障礙的中度OSAHS患者,隨機分為兩組,分別使用SOA治療或CPAP治療,并采用MOCA和PSG于治療前一周以及治療3個月后對患者行認(rèn)知功能檢查和PSG監(jiān)測。對所獲各項觀察指標(biāo)的數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)分析,以P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果 兩組中度OSAHS患者睡眠呼吸暫停低通氣指數(shù)(apnea hypopnea index,AHI)、最低血氧飽和度(lowest blood oxygen saturation,LSa O2)和MOCA評分在治療前1周及治療3個月后的差異有統(tǒng)計學(xué)意義(P0.01);兩治療組治療前后MOCA各項評分中注意力項和記憶項得分差異有統(tǒng)計學(xué)意義(P0.01);視空間/執(zhí)行功能項和抽象能力項SOA組得分差異有統(tǒng)計學(xué)意義(P0.01),CPAP組差異有統(tǒng)計學(xué)意義(P0.05);兩組的命名項、語言項和定向力項沒有差異(P0.05)。兩治療組治療后睡眠呼吸參數(shù)、MOCA總分及各項評分差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論 CPAP與SOA治療有認(rèn)知功能障礙中度OSAHS患者的客觀療效相當(dāng),都是治療有認(rèn)知功能障礙中度OSAHS患者的有效方法;二者在治療合并認(rèn)知功能障礙的中度OSAHS患者時,對于認(rèn)知功能的恢復(fù)有效且程度相當(dāng),在臨床皆可作為合并認(rèn)知功能障礙中度OSAHS患者的治療方式。
[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.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R766

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