阻塞性睡眠呼吸暂停低通气综合征患者认知障碍的研究

The study of cognitive impairment in patients with obstructive sleep apnea and hypopnea syndrome

目的应用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评估阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hypopnea syndrom,OSAHS)患者的认知功能。方法 OSAHS男性患者82例,根据呼吸暂停低通气指数(apnea hypopnea index,AHI)和最低血氧饱和度(SaO2),分为轻度组31例、中度组25例、重度组26例;健康男性20例为对照组。应用MoCA对各组患者进行评分。结果对照组、轻度组与中、重度组MoCA总分、注意力、延迟回忆评分组间比较,差异均有统计学意义(P均<0.05)。对照组与重度组视空间与执行功能、定向比较差异有统计学意义(P均<0.05),对照组与轻度组注意力差异有统计学意义(P<0.05);MoCA评分与SaO2呈正相关(P<0.01),与AHI、最长呼吸暂停时间(lon-gest apnea time,LAT)、血氧饱和度小于90%时间占睡眠时间百分比(saturation lower then 90%,SLT 90%)呈负相关(P<0.01)。结论 OSAHS患者出现轻度认知障碍风险增加;MoCA可以作为筛查OSAHS患者认知障碍的方法。

Objective To assess cognitive impairment of patients with obstructive sleep apnea and hypopnea syndrome（OSAHS） by montreal cognitive assessment（MoCA）.Methods Eighty two OSAHS patients were divided into three groups according to apnea hypopnea index（AHI） and longest apnea time（LAT）,including mild group,moderate and severe groups.The cognitive function was evaluated by MoCA.Results The parameters,including total scores of MoCA,attention,delayed recall in moderate and severe groups were lower than mild or control group（P0.05）.The visuospatial skills and orientation in severe groups were significantly lower than those in control group（P0.05）.The attention in mild groups were lower than that in control group（P0.05）.The total scores of MoCA were positive correlation with Minimal saturation of blood oxygen（P0.01）,and were negative correlation with AHI,LAT,and percentage of time spend when oxygen saturation lower than 90%（SLT 90%）（P0.01）.Conclusion The risk of MCI increased in OSAHS patients.MoCA could be used to evaluate the cognitive impairment in OSAHS patients.