成人OSAHS患者认知功能障碍影响因素及海马区磁共振波谱成像临床价值研究

发布时间：2018-01-16 15:07

本文关键词：成人OSAHS患者认知功能障碍影响因素及海马区磁共振波谱成像临床价值研究　出处：《中风与神经疾病杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的研究成人阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者认知功能障碍及影响因素,分析海马区磁共振波谱成像对OSAHS患者认知功能障碍的临床价值。方法纳入71例成年人,根据多导睡眠监测结果分为OSAHS组和非OSAHS组,比较两组基线资料、多导睡眠监测值、蒙特利尔认知评估(montreal cognitive assessment,MoCA)值、海马区磁共振波谱(magnetic resonance spectroscopy,MRS)值;对OSAHS组进行二元Logistic回归分析及MoCA总分与海马区MRS线性回归分析。结果 OSAHS组血红蛋白比非OSAHS组高(P0.05);OSAHS组在视空间与执行、延迟记忆、注意力、MoCA总分均低于非OSAHS组(P0.05);OSAHS组在呼吸暂停低通气指数(apnea-hypopnea index,AHI)、最长暂停时间、平均暂停时间均高于非OSAHS组,而最低血氧饱和度(SaO_2)、平均血氧饱和度(SaO_2)均低于非OSAHS组(P0.05);最低SaO_2可能是认知功能障碍的独立保护因素(P0.05);OSAHS组海马区MRS中N-乙酰天门冬氨酸/肌酸(NAA/Cr)、胆碱/肌酸(Cho/Cr)、N-乙酰天门冬氨酸/胆碱(NAA/Cho)均下降(P0.05);MoCA总分和NAA/Cr呈正相关(调整R2=0.63,P0.05)。结论 OSAHS认知功能障碍主要在视空间与执行、延迟记忆、注意力等方面;最低SaO_2可能是认知功能障碍的独立保护因素;OSAHS组NAA/Cr降低、Cho/Cr、NAA/Cho降低且NAA/Cr值随着MoCA总分降低而降低,说明MRS对客观评估OSAHS患者认知障碍及海马代谢变化方面具有重要的临床价值。
[Abstract]:Objective to study adult obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea-hypopnea syndrome, OSAHS) and the influence factors of cognitive dysfunction patients, clinical value analysis of hippocampal magnetic resonance spectroscopy on cognitive dysfunction in OSAHS patients. Methods into 71 cases of adults, according to the results of polysomnography were divided into OSAHS group and non OSAHS group comparison of two groups, the baseline data, polysomnography, Montreal cognitive assessment (Montreal cognitive, assessment, MoCA), hippocampal magnetic resonance spectroscopy (magnetic resonance spectroscopy, MRS); group OSAHS was two yuan Logistic regression and the total score of MoCA and MRS in hippocampus of linear regression analysis. Results in the OSAHS group than that of hemoglobin OSAHS group (P0.05); OSAHS group in the visual space and execution, delayed memory, attention, scores of MoCA were lower than group OSAHS (P0.05); OSAHS group in breathing Apnea hypopnea index (apnea-hypopnea, index, AHI), the longest pause time and average pause time were higher than non OSAHS group, and the lowest oxygen saturation (SaO_2), the average oxygen saturation (SaO_2) were lower than those in non OSAHS group (P0.05); SaO_2 is the lowest possible independent protective factors of cognitive function disorder (P0.05); OSAHS in MRS N- group in hippocampus of N-acetylaspartate / creatine (NAA/Cr), choline / creatine (Cho/Cr), N- N-acetylaspartate / choline (NAA/Cho) decreased (P0.05); the total score of MoCA and NAA/Cr were positively correlated (R2=0.63, P0.05). Conclusion OSAHS cognitive dysfunction mainly in the visual space and execution delay memory, attention and so on; the lowest SaO_2 may be the independent protective factors of cognitive impairment in OSAHS group; NAA/Cr Cho/Cr, NAA/Cho decreased, decreased and NAA/Cr value decreased with the total score of MoCA decreased, indicating that MRS of objective assessment of OSAHS patients with cognitive impairment and hippocampal generation The change of thanks has important clinical value.

【作者单位】：甘肃中医药大学临床医学院;达州市中西医结合医院神经内科;甘肃省人民医院中法神经康复科;甘肃省人民医院睡眠医学中心;甘肃省人民医院放射科;
【基金】：国家自然科学基金(No.81560228)
【分类号】：R749.1;R766
【正文快照】： 作者单位:(1.甘肃中医药大学临床医学院,甘肃兰州730000;2.甘肃省人民医院中法神经康复科,甘肃兰州730000;3.甘肃省人民医院睡眠医学中心,甘肃兰州730000;4.甘肃省人民医院放射科,甘肃兰州730000;5.达州市中西医结合医院神经内科,四川达州635000)阻塞性睡眠呼吸暂停低通气综合

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