低氧诱导因子-1与阻塞性睡眠呼吸暂停低通气综合征合并脑梗死患者认知功能的相关性研究

发布时间：2018-05-19 03:42

本文选题：睡眠呼吸暂停 + 阻塞性　；参考：《现代预防医学》2015年03期

【摘要】：目的探讨低氧诱导因子-1(HIF-1)与阻塞性睡眠呼吸暂停低通气综合症(OSAHS)合并脑梗死认知障碍的相关性。方法对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49例和单纯脑梗死组30例(对照组)。同时采集两组患者静脉血,以ELISA法测定所采集血清HIF-1浓度。结果与对照组比较,合并组患者MMSE及LOTCA各项评分均降低,血清HIF-1水平升高(P0.05);合并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HIF-1水平则显著升高,P均0.05;相关性分析显示:合并组HIF-1水平与MMSE、LOTCA评分中知觉、视运动组织、思维运作及总分均呈负相关(r=-0.66、-0.30、-0.44、-0.35、-0.50,P均0.05),与定向力的相关性未见有统计学意义(P0.05);同时,合并组MMSE评分与年龄、BMI、HIF-1、AHI、有慢性病呈负相关(r=-0.48、-0.53、-0.56、-0.76、-0.60,P均0.05),与受教育年限呈正相关(r=0.33,P0.05);与性别及梗死部位相关性未见有统计学意义(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AHI、HIF-1、慢性病。结论OSAHS合并脑梗死患者认知功能受损且与血清HIF-1水平升高有关。HIF-1可能参与了OSAHS加重脑梗死认知障碍的过程,但并不能特异说明其对具体哪项认知功能的受损有影响。
[Abstract]:Objective to investigate the relationship between hypoxic inducible factor-1 (HIF-1) and cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 79 patients with cerebral infarction were examined with polysomnography (PSG), simple intelligent screening (MMSEN) and Lothca (Lovenston task therapy cognitive assessment test). The patients were divided into OSAHS combined with cerebral infarction group (49 cases) and simple cerebral infarction group (30 cases) (control group). At the same time, the venous blood was collected from the two groups and the serum HIF-1 concentration was measured by ELISA method. Results compared with the control group, the scores of MMSE and LOTCA in the combined group were all lower, the serum HIF-1 level was higher than that in the control group, and the LOTCA scores in the patients with moderate and severe cognitive impairment were lower than those in the mild cognitive impairment group. The level of serum HIF-1 increased significantly (P < 0.05). The correlation analysis showed that there was a negative correlation between HIF-1 level and perception, visual motor tissue, thinking operation and total score in the combined group. In the combined group, the MMSE score was negatively correlated with the age of BMI-BMI-1HIF-1, and had a negative correlation with chronic diseases (P < 0.05), but had no significant correlation with sex and infarct location (P 0.05), and had a positive correlation with the years of education (P < 0.05), and had a positive correlation with the years of education (P < 0.05). Multiple stepwise regression analysis showed that the influencing factors related to cognitive function were AHIHIF-1 and chronic diseases. Conclusion the cognitive impairment in patients with OSAHS complicated with cerebral infarction may be related to the increase of serum HIF-1 level. HIF-1 may be involved in the process of exacerbating cognitive impairment of cerebral infarction by OSAHS, but it can not specifically explain which cognitive impairment can be affected by HIF-1.
【作者单位】：河北联合大学护理与康复学院;
【分类号】：R766;R743.3

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