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目的:分析OSAHS与脑卒后患者认知障碍及功能状态的相关性。方法:2014-02-2016-09期间共纳入189例符合研究标准的患者,剔除33例轻度OSAHS患者,86例研究组患者和70例对照组患者纳入最终分析。主要检测指标为认知状态和功能状态。认知状态由以下维度进行评估:警惕性、注意力、记忆力、工作记忆、执行力、语言、洞察力、精神活动、精神运动能力以及智力;利用神经状态和功能独立性评估功能状态。次要指标包括嗜睡、疲劳、焦虑和抑郁及睡眠质量。结果:研究组年龄大于对照组,BMI高于对照组,平均住院时间长于对照组,均差异有统计学意义(均P<0.05)。2组总认知状态差异明显,研究组明显差于对照组(t=9.276,P=0.012)。研究组患者的注意力、执行力、洞察力、心理调节能力和智力均低于对照组,差异有统计学意义(均P<0.05)。研究组较对照组患者的功能状态更差(t=38.094,P=0.000)。2组患者的次要指标包括嗜睡、疲劳、睡眠质量、焦虑和抑郁均差异无统计学意义(均P>0.05)。结论:伴OSAHS的脑卒中患者认知障碍和功能状态明显更差,OSAHS是脑卒中患者预后不良的危险因素。
Objective: To analyze the correlation between OSAHS and cognitive impairment and functional status in patients with stroke. METHODS: A total of 189 eligible patients were enrolled during the period 2014-02-2016-09, excluding 33 patients with mild OSAHS, 86 patients in the study group and 70 patients in the control group. The main test indicators for cognitive status and functional status. Cognitive status is assessed by the following dimensions: Vigilance, Attention, Memory, Working Memory, Execution, Language, Insight, Mental Activity, Mental Motorization, and Intelligence; Assessment of Functional Status Using Neurological and Functional Independence. Secondary indicators include drowsiness, fatigue, anxiety and depression, and quality of sleep. Results: The study group was older than the control group. The BMI was higher than that of the control group, and the average length of hospital stay was longer than that of the control group (all P <0.05). There was significant difference between the two groups in overall cognitive status, which was significantly worse in the study group than in the control group (t = 9.276, P = 0.012). Study group patients attention, executive ability, insight, mental adjustment and intelligence were lower than the control group, the difference was statistically significant (P <0.05). The study group had worse functional status than the control group (t = 38.094, P = 0.000). There was no significant difference between the two groups in secondary indicators including lethargy, fatigue, quality of sleep, anxiety and depression (all P> 0.05). Conclusions: Cognitive impairment and functional status are significantly worse in stroke patients with OSAHS. OSAHS is a risk factor for poor prognosis in patients with stroke.