摘要目的 研究非呼吸相关睡眠片段化对小动脉硬化性脑小血管病(CSVD)认知功能的影响.方法 研究对象为2017年8月至2018年7月期间中山大学附属第三医院神经内科门诊的小动脉硬化性CSVD患者72例,完成头颅磁共振血管成像(MRA)+磁敏感加权成像(SWI)检查及危险因素筛查,完成多导睡眠监测,排除呼吸相关睡眠障碍,以夜间觉醒次数中位数(19次)为界,将患者分为研究组(≥19次)和对照组(＜19次),比较两组之间认知功能差异,认知功能评估采用蒙特利尔认知量表(MoCA)和简明精神状态检查(MMSE).结果 研究组睡眠效率、快动眼睡眠比例、非快动眼-3期睡眠比例低于对照组,差异有统计学意义(P＜0.05);研究组MoCA总分[(18.2±4.3)分]、视空间分[(1.9±1.4)分]、延迟回忆分[(1.4±0.9)分]低于对照组[(22.7±3.5)分、(2.9±1.2)分、(2.9±1.1)分],差异有统计学意义(P＜0.05).结论 非呼吸相关睡眠片段化在CSVD患者中的发生率高,睡眠片段化和认知损害有关.

abstractsObjective To investigate the effect of non-breathing-related sleep fragmentation on cognitive function in patients with atherosclerotic cerebral small vessel disease(CSVD).Methods Seventy-two patients with arteriosclerotic CSVD in the Department of Neurology,the Third Affiliated Hospital of Sun Yat-sen University were enrolled in this study from August 2017 to July 2018.The patients undertook MRA(Magnetic Resonance Angiography) + SWI(Susceptibility weighted imaging),polysomnography,Montreal Cognitive Inventory (MoCA) and Concise Mental State Examination (MMSE).The patients were divided into study group (≥19) and control group(＜19)according to the median number of arousal events (median=19) at night.Results The sleep efficiency,rapid eye movement (REM) sleep ratio and non-rapid eye movement-3 (NREM-3) sleep ratio of the study group were significantly lower than those of the control group (P＜0.05),and the total MoCA score(18.2±4.3),visual space score(1.9± 1.4) and delayed recall score(1.4±0.9) of the study group were significantly lower than those of the control group (22.7±3.5,2.9±1.2,2.9±1.1,P＜0.05).Conclusion The incidence of non-breathing-related sleep fragmentation is high in CSVD patients and this kind of fragmentation is associated with cognitive impairment.