阻塞性睡眠呼吸暂停低通气综合征患者综合治疗后认知功能及血清IGF-1的变化及意义

Changes and Significance of Cognitive Function and Serum IGF-1 in Patients with Obstructive Sleep Apnea Hypopnea Syndrome after Comprehensive Treatment.

目的探讨阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea-hypopnea syndrome,OSAHS)患者行经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)联合悬雍垂腭咽成形术的综合治疗后认知功能及血清胰岛素样生长因子-1(Insulin-1ike Growth Factor-1,IGF-1)水平的变化及意义。方法选择90例经多导睡眠监测(Polysomngraphy PSG)诊断的中重度OSAHS患者作为观察组,包括中度组40例,重度组50例;另选择同时期40例单纯鼾症患者(AHI<5)作为对照组。治疗前及综合治疗后6个月分别监测患者最低血氧饱和度(Lowest oxygen saturation,LSaO2)、呼吸暂停低通气指数(Apnea hypopnea index,AHI)、血清IGF-1水平及蒙特利尔认知评分(MoCA),并进行比较,观察治疗效果,并分析血清IGF-1与认知功能的相关性。结果综合治疗前观察组患者IGF-1水平(18.34±8.55)ng/ml及MoCA(22.58±2.26),与对照组比较差异均有统计学意义(P<0.05);观察组OSAHS患者综合治疗前、后的AHI指数明显下降,LSaO2、IGF-1水平及MoCA评分显著升高,两者分别比较差异有统计学意义(P<0.05)。综合治疗前,MoCA评分与血清IGF-1水平及LSaO2呈正相关,与AHI指数呈负相关。结论OSAHS患者血清IGF-1水平与认知功能障碍及病情严重程度相关,综合治疗在改善睡眠质量的同时,也提高血清IGF-1水平,改善认知功能。

Objective To investigate the cognitive function and serum insulin-like growth factor-1(IGF-1 water in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)after nasal continuous positive airway pressure(nCPAP)combined with uvulopalatopharyngoplasty.The change and significance of Ping.Methods 90 patients with moderate to severe OSAHS diagnosed by polysomnography(PSG)were selected as observation group,including 40 patients in moderate group and 50 patients in severe group,and 40 patients with simple snoring(AHI<5)in the same period were selected as control group.Lowest oxygen saturation(LSaO2),apnea hypopnea index(AHI),serum IGF-1 level and Montreal Cognitive Score(MoCA)were monitored before treatment and 6 months after comprehensive treatment.The therapeutic effect was observed and the correlation between serum IGF-1 and cognitive function was analyzed.Results The levels of IGF-1(18.34±8.55)ng/ml and MoCA(22.58±2.26)in the observation group before and after comprehensive treatment were significantly lower than those in the control group(P<0.05);the AHI index in the observation group before and after comprehensive treatment was significantly lower,and the levels of LSa O2,IGF-1 and MoCA scores were significantly higher than those in the control group(P<0.05).Before comprehensive treatment,MoCA score was positively correlated with serum levels of IGF-1 and LSa O2,and negatively correlated with AHI index.Conclusion Serum IGF-1 level is correlated with cognitive impairment and severity of OSAHS.Comprehensive treatment can improve sleep quality,serum IGF-1 level and cognitive function.