阻塞性睡眠呼吸暂停低通气综合征患者的人格心理特征及社会功能的相关分析

摘要

目的：调查分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的人格心理特征。方法参考多导睡眠监测(PSG)结果,将确诊的60例OSAHS患者和30例单纯鼾症患者(对照组)纳入本研究,采用Epworth嗜睡程度量表(ESS)和多次小睡潜伏期测验(MSLT)评价患者的日间嗜睡情况,采用明尼苏达多相人格量表(MMPI)评估患者的人格心理状况；采用简明健康状况调查表(SF-36)、疲劳量表(FS-14)、注意缺陷量表分别评价患者生活质量、疲劳程度、注意缺陷程度。结果①与对照组相比,OSAHS 组 MMPI 疑病分量表(Hs)平均得分更高[(56.0±9.1)vs.(52.0±6.6),P<0.05],高T分临床分量表(T分数>60分)的平均个数更多[(2.4±2.1)vs.(0.6±1.0),P<0.01],OSAHS组 Hs、Hy、Pd、D、Pt、Sc分量表T分数得分>60分的患者例数高于对照组(P<0.05或0.01)。②MMPI测图中高T分分量表数≥4的患者(残疾组)SF-36总分和各维度平均分均低于高 T 分分量表数=0的患者(正常组),FS-14、注意缺陷平均分高于正常组；2≤高 T 分分量表数≤3的患者(中度异常组)SF-36总分和大部分维度平均分低于正常组,注意缺陷平均分高于正常组。③在所有受试者中,MMP I 总平均分与总睡眠时间(TST)、总微觉醒指数(TAI)、SF-36总分及各维度平均分呈负相关(P<0.05或0.01),与 FS-14、注意缺陷平均分呈正相关(P<0.01)。结论与单纯鼾症患者相比,OSAHS患者表现了更多的疑病、抑郁、癔症、精神病态行为、精神衰弱和精神分裂症等人格心理问题。OSAHS患者和单纯鼾症患者的夜间睡眠时间、睡眠的连续性和白天功能可能受到其心理症状严重程度的影响。%Objective To investigate the psychopathology and Personality characteristics in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods 60 OSAHS patients and 30 snorers were tested by the Multiple sleep latency test (MSLT),the Epworth sleepiness scale (ESS),the Minnesota Multiphasic Personality Inventory (MMPI),the Short-Form 36 item Health Survey questionnaire (SF-36),the fatigue scale (FS-14),the attention-deficit scale.Results Com-pared to the snorers,OSAHS patients have significantly higher absolute scores on hypochondriasis (Hs)(56.0±9.1 vs.52.0 ±6.6,P <0.05),greater the number of clinical elevations(2.4±2.1 vs.0.6±1.0,P <0.01),higher the rate of clinical el-evation on Hs,depression(D),hysteria(Hy),psychopathic deviate(Pd),psychasthenia(Pt),schizophrenia(Sc).People with the disability profile have a lowest quality of life,highest inattention scores,highest fatigue scores.People with two or three clinical elevations have a lower quality of life,higher inattention scores,higher fatigue scores.When the quality of life scores, TST and TAI were negatively correlated with total MMPI Score,the attention-deficit scores and fatigue scores were positively correlated with total MMPI Score.Conclusion Patients with OSAHS compared to snorers displayed significantly more hypochondriasis, depression,hysteria,psychopathic deviate,Psychasthenia,Schizophreia personality characteristics.The TST,TAI and daytime functions in patients with sleep disor-dered breathing may be influenced by the severity of psychopathology.