脑梗死合并阻塞性睡眠呼吸暂停低通气综合征患者血清脑红蛋白的变化及意义

发布时间：2019-03-22 07:33

【摘要】：目的通过对脑梗死合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清脑红蛋白(NGB)水平的检测分析,探讨NGB在OSAHS合并脑梗死认知障碍发生中的作用。方法对经头颅CT或MRI证实的79例脑梗死患者均进行多导睡眠图(PSG)、简易智能筛查(MMSE)、洛文斯顿作业疗法认知评定成套测验(LOTCA)检测,分为OSAHS合并脑梗死组(观察组)49例和单纯脑梗死组(对照组)30例。同时采集两组患者静脉血,以ELISA法测定所采集血清NGB浓度。结果与对照组比较,观察组患者MMSE及LOTCA各项评分均降低,血清NGB水平升高(P0.05);观察组内中重度认知障碍患者的LOTCA各项评分均低于轻度认知障碍组,血清NGB水平则显著升高(均P0.05);相关性分析显示:观察组NGB水平与MMSE、LOTCA评分中视运动组织、思维运作及总分均呈负相关(r=-0.48、-0.55、-0.68、-0.79,均P0.05),与定向力、知觉的相关性无统计学意义(P0.05);同时,观察组MMSE评分与年龄、体重指数(BMI)、NGB、呼吸暂停低氧指数(AHI)、有慢性病呈负相关(r=-0.42、-0.59、-0.79、-0.78、-0.59,均P0.05),与受教育年限呈正相关(r=0.34,P0.05);与性别及梗死部位相关性无统计学意义(P0.05)。多元逐步回归分析显示:与认知功能有关的影响因素依次是NGB、AHI、慢性病。结论脑梗死合并OSAHS患者认知功能受损与血浆NGB水平升高有关。
[Abstract]:Aim to investigate the role of (OSAHS) in the pathogenesis of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by detecting and analyzing the level of serum (NGB) in patients with cerebral infarction and obstructive sleep apnea hypopnea syndrome (OSAS). Methods 79 patients with cerebral infarction confirmed by CT or MRI were examined with (LOTCA) by simple and intelligent screening with polysomnography (PSG),) for (MMSE), Lovingston occupational therapy cognitive assessment kit. Forty-nine patients with OSAHS combined with cerebral infarction (observation group) and 30 patients with simple cerebral infarction (control group) were divided into two groups. At the same time, the venous blood of the two groups was collected and the concentration of serum NGB was determined by ELISA method. Results compared with the control group, the scores of MMSE and LOTCA in the observation group were lower than those in the control group, and the level of serum NGB was higher (P0.05). The LOTCA scores of patients with moderate or severe cognitive impairment in the observation group were lower than those in the mild cognitive impairment group, while the serum NGB level was significantly higher (all P0.05). Correlation analysis showed that the level of NGB in observation group was negatively correlated with visual motor organization, thinking operation and total score in MMSE,LOTCA score (r = 0.48, 0.55, 0.68, 0.79, all P0.05). The correlation of perception was not statistically significant (P0.05); At the same time, the MMSE score of observation group was negatively correlated with age, body mass index (BMI), NGB,) apnea hypoxia index (AHI),) of chronic diseases (r = 0.42, 0.59, 0.79, 0.78, 0.59, all P0.05). There was a positive correlation between the number of years of education (r = 0.34, P0.05); There was no significant correlation between sex and infarction site (P0.05). Multiple stepwise regression analysis showed that NGB,AHI, chronic diseases were related to cognitive function. Conclusion the impairment of cognitive function in patients with cerebral infarction complicated with OSAHS is related to the increase of plasma NGB level.
【作者单位】：天津市第五中心医院;华北理工大学附属医院;
【分类号】：R743.3;R766

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