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(P<0.05);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(P<0.05);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(P<0.05);最低SaO_2可能是认知功能障碍的独立保护因素(P<0.05);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(P<0.05);MoCA总分和NAA/Cr呈正相关(调整R2=0.63,P<0.05)。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。
Objective To explore the characteristics and influence factors of cognitive dysfunction in adult patients with obstructive sleep apnea-hypopnea syndrome(OSAHS),and analyze the value of magnetic resonance spectrum of hippocampal region on cognitive dysfunction.Methods Basing on result of multi guide sleep monitoring,71 adults were divided into OSAHS group and no-OSAHS group.Baseline data for both groups,multi guide sleep monitoring value,Montreal cognitive assessment(MoCA) scale and magnetic resonance spectrum(MRS) of hippocampal region were compared.Binary Logistic regression analysis was performed for cognitive dysfunction group and relationship between MoCA total score and MRS of hippocampal with linear regression was analyzed.Results Compared with the non-OSAHS group,hemoglobin value were higher(P〈0.05).The OSAHS group had lower scores than,the cognitive normal group in visual space and execution delayed memory,attention and MoCA value.Cognitive dysfunction in apnea-hypopnea hypoventilation index(AHI),the longest pause time,average pause time were higher than cognitive normal group,while the minimum blood oxygen saturation(SaO_2)was lower than cognitive normal group(P〈0.05).Minimum SaO_2 may be independent protective factors for cognitive dysfunction.The N-acetylasparagine/Creatine(NAA/Cr),Choline/Creatine(Cho/Cr),N-acetylasparagine/Choline(NAA/Cho) went down in MRS of hippocampus region of cognitive dysfunction group(P〈0.05).The total score of MoCA was positively correlated with the NAA/Cr(adjusted R2=0.63,P〈0.05).Conclusion The cognitive dysfunction of OSAHS mainly included visual space,execution and delayed memory and attention,minimum SaO_2 may be independent protective factors for cognitive dysfunction,NAA/Cr value was decreased with MoCA total score.It was shown that MRS may have important clinical value in evaluating the cognitive impairment and metabolic changes of hippocampus in OSAHS patients.
出处
《中风与神经疾病杂志》
北大核心
2017年第10期878-882,共5页
Journal of Apoplexy and Nervous Diseases
基金
国家自然科学基金(No.81560228)
关键词
阻塞性睡眠呼吸暂停低通气综合征
认知功能障碍
海马
磁共振波谱成像
Obstructive sleep) apnea-hypopnea syndrome
Cognitive d ysfu nc tion
H ip po c am p u s
M ag -netic resonance spectrum