摘要
目的:探讨OSAHS患者认知功能和言语识别能力的关系。方法选择青年男性 OSAHS 患者60例,年龄18~40岁,根据临床诊断标准及多导睡眠图(polysomnogram,PSG)结果将患者按照呼吸暂停低通气指数(AHI)及低氧血症程度分为:轻度组19例,中度组20例,重度组21例;对照组为正常青年男性(年龄18~40岁)25例。对各组首先进行蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)测试,然后应用普通话言语测听材料(MSTMs)中的15张句表(每表50个关键词)进行言语识别测试。结果①对照组和轻、中、重度 OSAHS患者组 MoCA得分总分分别为:28.52±1.16、27.32±1.16、25.85±1.23、24.52±1.69分,四组之间两两比较差异均有统计学意义(P<0.01)。②刺激声强度为22、24、26 dB SPL时,重度OSAHS患者的言语识别率(%)分别为:35.4±22.6、56.3±23.9、75.2±16.5,较轻度组(38.4±23.5、58.3±25.5、79.2±18.5)、中度组(38.8±21.6、58.7±22.7、78.5±16.7)、对照组(39.4±23.5、60.3±24.3、80.2±16.4)均降低(P均<0.05)。③各组50%识别率所需的给声强度分别为:轻度组3.66±0.50 dB SPL、中度组3.72±0.55 dB SPL、重度组4.15±0.80 dB SPL、对照组3.62±0.41 dB SPL,重度组与其余三组比较差异有统计学意义(P<0.01)。结论 OSAHS患者随着缺氧和病情程度加重,言语识别能力呈下降趋势,这可能是认知评估量表得分降低的重要相关因素。
Abstract
Objective To study the relationship between the cognitive function and speech recognition ability in young patients with OSAHS.Methods We selected 60 young male patients,according to the apnea-hypopnea index(AHI)and the severity of hypoxemia.They were divided into three subgroups on the basis of their syndrome severities:mild group (n= 19;AHI 5~15/h,85%≤minimum SaO2≤90%),moderate group (n= 20;AHI>15~30/h,80%≤minimum SaO2<85%),and severe group (n= 21;AHI>30/h,minimum SaO2<80%).First,we used the MoCA scale for cognitive function tests and recorded the scores.Then 15 lists of sentence Mandarin Speech Test Materials(MSTMs)were utilized to test each group.A data analysis was performed using SPSS 17.0 software. Results The total MoCA scores(mild group:27.32±1.16;moderate group:25.85±1.23;severe group:24.52± 1.69;control group:28.52 ±1.16)decreased progressively as the disease severity increased,showing significant differences between the control group and the mild,moderate and severe groups of OSAHS patients (allP<0.05). When sound stimuli were presented at 22,24,and 26 dB SPL,the speech recognition rates in the patients with se-vere(35.4±22.6,56.3±23.9,75.2±16.5)lower than the other groups (mild group:38.4±23.5,58.3±25.5,79.2 ±18.5;moderate group:38.8±21.6,58.7±22.7,78.5±16.7;control group:39.4±23.5,60.3±24.3,80.2±16.4, respectively,allP<0.05).The differences in intensity of 50% recognition rate between the severe group(4.15± 0.80)and the control(3.62±0.41),mild (3.66±0.50)and moderate groups(3.72±0.55)of OSAHS patients were statistically significant(allP<0.05).Conclusion With hypoxia and disease severity increased,speech recogni-tion abilities in OSAHS patients decreased.This may be an important factor associated with cognitive assessment scale score.