刘萍 邱大宏 吴喜强 陈艺军 李鹏辉

[摘要] 目的 观察阿尔茨海默病患者睡眠障碍与认知功能的相关性。 方法 采用整群抽样方法选取2011年10月～2015年3月在我院住院的阿尔茨海默病患者进行研究。纳入患者中根据患者的主诉及匹兹堡睡眠质量指数（PQSI）量表评分情况，有睡眠障碍主诉且PQSI≥7分的患者共42例，设为睡眠障碍组；PQSI<7分的患者有40例，设为无睡眠障碍组。采用PQSI评价患者的睡眠障碍状况，采用简易精神状态检查（MMSE）量表评价患者的认知功能。 结果 睡眠障碍组患者睡眠质量、入睡困难、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍得分及总得分均高于无睡眠障碍组（均P<0.05）。睡眠障碍组MMSE量表评分得分低于无睡眠障碍组（t=3.34，P<0.05）。有睡眠障碍的患者其睡眠障碍与认知功能呈明显负相关（r=-0.41，P<0.05）。 结论 阿尔茨海默病患者的睡眠障碍与认知功能密切相关，可引起认知功能的减退。

[关键词] 阿尔茨海默病；睡眠障碍；认知功能；匹兹堡睡眠质量指数量表；简易精神状态检查量表

[中图分类号] R749.1+6 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0017-03

Correlation study of sleep-disorder and cognitive function in patients with Alzheimer disease

LIU Ping QIU Da-hong WU Xi-qiang CHEN Yi-jun LI Peng-hui

Department of Psychiatry，the Second People′s Hospital of Huizhou City in Guangdong Province，Huizhou 516001，China

[Abstract] Objective To observe the occurrence of sleep-disorder in patients with Alzheimer disease and explore the correlation between sleep-disorder and cognitive function. Methods By a cluster sampling，patients with Alzheimer disease admitted into our hospital from October 2011 to March 2015 were selected for research.According to patient′s chief complain and Pittsburgh sleep quality index （PSQI） scoring，they were divided into sleep-disorder group including 42 patients with chief complain of sleep-disorder and PSQI being no less than 7 points and no sleep-disorder group including 40 patients whose PSQI was lower than 7 points.The status of sleep-disorder was evaluated by PSQI and patient′s cognitive function was assessed by mini-mental state examination（MMSE）. Results In the sleep-disorder group，scores of sleep quality，difficulty in falling asleep，sleep time，sleep efficiency，sleep disturbance，daytime dysfunction and total score was higher than that in the no sleep-disorder group respectively（all P<0.05）.Score of MMSE in the sleep-disorder group was lower than that in the no sleep-disorder group（t=3.34，P<0.05）.Analysis outcome indicated that there was an obvious negative correlation between sleep-disorder and cognitive function in patients with sleep disorders（r=-0.41，P<0.05）. Conclusion The sleep-disorder is closely related with cognitive function in patients with Alzheimer disease and may lead to impairment of cognitive function.

[Key words] Alzheimer disease；Sleep disorder；Cognitive function；Pittsburgh sleep quality index；Mini-mental state examination

阿尔茨海默病（Alzheimer disease，AD）是一种发病过程缓慢，且随着发病进展神经功能逐渐恶化的慢性中枢神经系统性疾病。较常见的临床表现为逐渐出现记忆力下降，及语言功能、视空间功能、失认、失用等认知功能的障碍。目前阿尔茨海默病具体的发病机制尚未明确，有研究认为，阿尔茨海默病是基因与环境因素相互作用的结果，年龄、性别、颅脑损伤和生活习惯改变等是其潜在的危险因素[1]。相关研究也证实，睡眠障碍是阿尔茨海默病的一个危险因素，约有44%的患者伴有睡眠障碍[2]。本研究对阿尔茨海默病患者进行睡眠障碍和认知功能测试，研究两者之间的关系，旨在进一步观察睡眠障碍对认知功能的影响，为临床采用合适的睡眠治疗及护理方法以提高患者的睡眠质量、减缓患者的认知功能提供临床依据。

1 资料与方法

1.1 一般资料

采用整群抽样方法选取2011年10月～2015年3月在我院住院的阿尔茨海默病患者，患者符合《中国精神疾病分类方案与诊断标准（第3版）》（CCMD-3）[3]中对阿尔茨海默病的诊断标准。……