慢性阻塞性睡眠呼吸暂停综合征白质脑病与认知功能改变关系的研究

Relationship between leukoencephalopathies and cognition disorder in patients with OSAS

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)白质变化与认知功能改变的关系,为OSAS认知功能损害的预防和治疗提供依据。方法选择OSAS患者63例,依据睡眠呼吸暂停低通气指数分成轻度、中度、重度3组,同时选取20例非OSAS作为对照组,均进行头颅MRI检查,观察脑白质的头颅MRI表现,并进行MMSE评分。结果 63例OSAS患者,头颅MRI显示44例脑白质改变,轻度组8例(50.00%)、中度组13例(68.42%)、重度组23例(82.14%),与对照组(2例)差异有统计学意义(χ2=11.59,P<0.05);MMSE评分4组差异有统计学意义(F=3.055,P<0.05)。结论 OSAS可以影响脑白质改变的发生发展,并且可能与患者的认知功能相关。因此干预OSAS可能减轻脑白质改变,进而减少认知功能障碍的发生。

Objective To investigate the relationship between leukoencephalopathies and cognition disorder in patients with obstructive sleep apnea syndrome （OSAS）, so as to provide the evidence for prevention and treatment of mild cognitive impairment. Methods A total of 63 patients with OSAS were assigned into the mild, medium, and severe groups according to their apnea hylzopnea indexes, and 20 individuals without OSAS served as controls. All the patients and controls were conducted with MRI examinations to observe the changes of white matter damage, and MMSE was evaluated on the patients and controls. Results Among the 63 patients, there were 44 patients who had the white matter damages, including 8 patients of the mild group, 13 patients of the medium group, and 23 patients of the severe group. Two individuals of the control group had abnormal white matter, and the difference was statistically significant between the OSAS group and the control group （ P 〈 0.05）. Conclusions may lead to white matter damages. Therefore, the treatment of OSAS may relieve the white matter changes, and also reverse the impairment of cognitive.