重度阻塞性睡眠呼吸暂停低通气综合征患者血清缺氧诱导因子-1α和胰岛素样生长因子-1及脑源性神经营养因子与认知功能的关系

发布时间：2018-03-31 09:56

本文选题：睡眠呼吸暂停低通气综合征　切入点：阻塞性　出处：《临床耳鼻咽喉头颈外科杂志》2014年12期

【摘要】：目的:探讨缺氧诱导因子-1α(HIF-1α)、胰岛素样生长因子-1(IGF-1)及脑源性神经营养因子(BDNF)在重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清中的变化及与认知功能改变的关系。方法:纳入经多导睡眠监测确诊OSAHS的患者67例(OSAHS组),同时选取17例健康人作为对照组。运用蒙特利尔认知评估量表(MoCA)对其进行认知功能评估,根据分值分为认知功能正常组(MoCA≥26)及认知功能异常组(MoCA26),采用酶联免疫吸附法测定血清中HIF-1α、IGF-1及BDNF水平。结果:OSAHS组共筛查出MCI 20例,对照组无认知功能异常者,两组比较差异有统计学意义(P0.05)。对照组与认知功能正常组比较HIF-1α、IGF-1存在差异(分别P0.05和P0.01),BDNF、BMI无明显差异(P0.05);对照组与认知功能异常组比较HIF-1α、BDNF存在差异(均P0.05),IGF-1、BMI无明显差异(P0.05);认知功能正常组与异常组比较IGF-1、BDNF存在明显差异(分别P0.01和P0.05),HIF-1α、BMI无明显差异(P0.05)。认知功能正常组血清BDNF与IGF-1呈正相关(r=0.663,P0.01),BDNF与HIF-1α呈正相关(r=0.562,P0.01),IGF-1与HIF-1α呈正相关(r=0.657,P0.01);三者分别与AHI、MoCA及BMI比较无明显相关(P0.05)。认知功能异常组血清BDNF与MoCA呈正相关(r=0.304,P0.05);其余各因素相互间无明显相关性(P0.05)。结论:①重度OSAHS患者与健康人比较存在轻度认知障碍;②重度OSAHS认知功能正常者的血清HIF-1α、IGF-1及BDNF三者水平密切相关,认知功能异常者的血清HIF-1α、IGF-1及BDNF三者水平无明显相关;③血清HIF-1α、IGF-1及BDNF三种物质可能共同参与并维持机体正常认知功能,IGF-1、BDNF对机体认知功能变化较为敏感。
[Abstract]:Objective: to investigate the changes of serum levels of hypoxia-inducible factor-1 伪 (HIF-1 伪), insulin-like growth factor-1 (IGF-1) and brain-derived neurotrophic factor (BDNF) in patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) and their relationship with cognitive function. Methods: 67 patients with OSAHS diagnosed by polysomnography and 17 healthy subjects were selected as control group, and their cognitive function was evaluated by Montreal Cognitive Assessment scale (MOCA). The serum levels of HIF-1 伪 -IGF-1 and BDNF were measured by enzyme-linked immunosorbent assay (Elisa). Results 20 cases of MCI were screened in the control group and 20 cases in the control group. There was significant difference between the two groups (P 0.05). There was no significant difference in HIF-1 伪 -IGF-1 between the control group and the normal cognitive function group (P 0.05 and P 0.01 respectively), and there was no significant difference between the control group and the cognitive dysfunction group (P 0.05). There were significant differences between normal cognitive function group and abnormal group (P0.01 and P0.05 respectively. There was no significant difference in serum BDNF and IGF-1 between normal cognitive function group and normal group. There was a positive correlation between HIF-1 伪 and BDNF in normal cognitive function group, and there was a positive correlation between HIF-1 伪 and IGF-1 in normal cognitive function group. There was no significant correlation between BMI and MoCA. There was no significant correlation between serum BDNF and MoCA in patients with cognitive dysfunction. There was no significant correlation between other factors. Conclusion there is mild cognitive impairment and severe OSAHS in patients with severe OSAHS at 1: 1 compared with those in healthy persons. The levels of serum HIF-1 伪 -IGF-1 and BDNF were closely related to those of normal subjects. There was no significant correlation between the levels of serum HIF-1 伪 -IGF-1 and BDNF in patients with abnormal cognitive function. Serum HIF-1 伪 -IGF-1 and BDNF may participate in and maintain normal cognitive function. IGF-1 is more sensitive to the changes of cognitive function.
【作者单位】：山东大学齐鲁医院耳鼻咽喉头颈外科卫生部耳鼻喉科学重点实验室;
【分类号】：R563.8

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