摘要
目的探讨阿尔茨海默病(AD)患者食欲素A(Orexin-A,OXA)水平与精神症状、睡眠质量、嗜睡状况、认知功能的关系。方法采用病例对照研究的方法,选取60例AD患者(病例组)和相匹配的60名普通志愿老年人(对照组),应用酶联免疫法测定血浆OXA水平,神经精神科问卷知情者中文版(NPI-Q)、匹兹堡睡眠质量指数(PSQI)、修订版艾普沃斯嗜睡量表(mESS)、简明精神状态检查量表(MMSE)评估其精神症状、睡眠质量、嗜睡状况和认知功能。1年后对病例组复测上述指标。结果基线时病例组OXA、NPI-Q、PSQI高于对照组,而MMSE低于对照组(P<0.05)。病例组治疗1年后OXA、NPI-Q均高于对照组,而MMSE仍低于对照组(P<0.05)。病例组治疗1年后OXA、PSQI、MMSE均低于基线时水平(P<0.05)。Logistic分析发现OXA水平是AD的危险因素,而MMSE得分则是AD的保护性因素(P<0.05)。病例组49例患者完成1年后的随访,发现OXA的变化与NPI-Q、PSQI、mESS的变化及使用抗精神病药均呈正相关(P<0.05),而与使用苯二氮类药、MMSE的变化均呈负相关(P<0.05);Logistic分析发现年龄大是MMSE改善的危险因素,OXA变化大则是其保护因素(P<0.05)。结论OXA是AD形成的危险因素之一,且影响其精神症状、睡眠质量、嗜睡和认知功能。
Objective To explore the relationships among orexin-A(OXA),psychiatric symptoms,sleep quality,sleepiness and cognitive functions in patients with Alzheimer’s disease(AD).Methods In this case-control study,60 patients with AD in case group and 60 matched healthy volunteers in control group were selected and detected by enzyme-linked immunosorbent assay(ELISA)for OXA levels in plasma.Neuropsychiatric Inventory-Questionnaire(NPI-Q),Pittsburgh Sleep Quality Index(PSQI),modified Epworth Sleepiness Scale(mESS),Mini-Mental State Examination(MMSE)were used to evaluate the psychiatric symptoms,sleep quality,sleepiness and cognitive functions.And these indicators in case group were examined again after one year’s following-up.Results At the baseline,the OXA level and total scores of NPI-Q,PSQI in case group were significantly higher than those in control group(P<0.05),but the total score of MMSE in case group was significantly lower than that in control group(P<0.05).At the end of the 1st year after treatment,the OXA level and the total score of NPI-Q in case group were all significantly higher than those in control group,and the total score of MMSE in case group was still significantly lower than that in control group(P<0.05);the OXA level and total scores of PSQI,MMSE in case group decreased significantly compared with those at the baseline(P<0.05).Logistic analysis showed that the OXA level was the risk factor,but the MMSE score was the protective factor for AD(P<0.05).A total of 49 patients in case group had completed the one-year following-up.It was found that the change of OXA was positively correlated with the changes of NPI-Q,PSQI,mESS and using antipsychotics(P<0.05),but was negatively correlated with the change of MMSE and using benzodiazepines(P<0.05).Logistic analysis showed that older age was the risk factor,but the more change of OXA was the protective factor for the improvement of MMSE(P<0.05).Conclusion The OXA level is a risk factor for AD,which furthermore effects the psychiatric symptoms,sleep qualit
作者
宋云
赵伟
郑梅梅
殷昊
孙丽丽
唐吉友
陈旭
SONG Yun;ZHAO Wei;ZHENG Meimei(The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan 250014, China)
出处
《精神医学杂志》
2021年第2期132-135,共4页
Journal of Psychiatry
基金
山东省医药卫生科技发展计划面上项目(编号:2015WS0227,2011WS0153)。
