阻塞性睡眠呼吸暂停低通气综合征老年患者神经营养因子水平与认知功能的相关性

发布时间：2018-05-27 04:05

本文选题：睡眠呼吸暂停 + 阻塞性　；参考：《安徽医药》2016年01期

【摘要】：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清神经营养因子水平的变化及其与认知功能间的相关性。方法按顺序纳入该院2013年5月至2014年9月收治的患者77例,参照呼吸暂停低通气指数(AHI)标准分为轻度OSAHS组25例、中度OSAHS组25例和重度OSAHS组27例;同时选择25例体检者作为健康对照组;分别进行多导睡眠图(PSG)监测;采用蒙特利尔认知评估量表(Mo CA)和简易智能状态量表(MMSE)对各组的认知功能进行评价;并检测血清神经生长因子(NGF),脑源性神经营养因子(BDNF),胶质细胞源性神经营养因子(GDNF)和睫状神经营养因子(CNTF)水平。分析以上参数间的相关性。结果与对照组比较,轻、中和重度OSAHS组患者的AHI、氧减指数(ODI)、呼吸相关微觉醒指数(RI)和脉氧饱和度低于90%的时间占总睡眠时间的百分比(TS90%)均明显升高(P0.01),且重度组较轻和中度组升高更明显(P0.01);而重度组患者的最低脉氧饱和度(LSa O2)和平均脉氧饱和度(MSa O2)较对照组明显降低(P0.01);与对照组比较,重度OSAHS组患者的Mo CA、MMSE评分显著降低(P0.01);与轻、中度OSAHS组相比,重度OSAHS组MoCA评分显著降低(P0.01)。与对照组比较,轻、中和重度OSAHS组患者血清神经营养因子水平均减少;而重度OSAHS组患者血清营养因子较对照组、轻和中度OSAHS组患者明显减少,比较差异有统计学意义(P0.01)。血清营养因子水平与睡眠呼吸记录指标AHI、ODI、RI和TS90%呈负相关,而与最低Sa O2和平均Sa O2呈正相关。血清营养因子水平与认知功能指标Mo CA和MMSE均呈正相关。结论血清神经营养因子水平是反映OSAHS患者的重要指标,且与其认知功能障碍密切相关。
[Abstract]:Objective to investigate the changes of serum neurotrophic factor level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and its correlation with cognitive function. Methods 77 patients admitted in our hospital from May 2013 to September 2014 were divided into mild OSAHS group (25 cases), moderate OSAHS group (25 cases) and severe OSAHS group (27 cases) according to the criteria of apnea hypopnea index (AHII). At the same time, 25 healthy persons were selected as the healthy control group, the polysomnography (PSG) was monitored, and the cognitive function of each group was evaluated by the Montreal Cognitive Assessment scale (MMSE) and the simple Mental State scale (MMSE). The serum levels of NGF, BDNF, GDNF and CNTFwere determined. The correlation between the above parameters is analyzed. Results compared with the control group, it was light, The AHI, oxygen reduction index (ODI), respiratory arousal index (RI) and the percentage of pulse oxygen saturation less than 90% of the total sleep time in the moderate and severe OSAHS group were significantly higher than those in the mild and moderate group, and those in the severe group were significantly higher than those in the mild and moderate group. The lowest pulse oxygen saturation (LSAO _ 2) and mean pulse oxygen saturation (MSA _ O _ 2) in the severe group were significantly lower than those in the control group (P 0.01). The MMSE scores of severe OSAHS patients were significantly lower than those of mild and moderate OSAHS groups, and the MoCA scores of severe OSAHS group were significantly lower than those of mild and moderate OSAHS groups. Compared with the control group, the level of serum neurotrophic factor in the mild, moderate and severe OSAHS group was decreased, while in the severe OSAHS group, it was significantly lower than that in the control group, mild and moderate OSAHS group, and the difference was statistically significant (P 0.01). The levels of serum nutritional factors were negatively correlated with the sleep respiratory record index AHI ODI RI and TS90%, but positively correlated with the lowest SaO2 and average SaO2. The level of serum nutrition factor was positively correlated with Mo CA and MMSE. Conclusion the level of serum neurotrophic factor is an important index to reflect the patients with OSAHS and is closely related to its cognitive dysfunction.
【作者单位】：湖北省中山医院呼吸内科;襄阳市中心医院呼吸内科;
【分类号】：R766;R749.1

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