阻塞性睡眠呼吸暂停综合征事件相关电位和记忆功能的相关性

Event-related potentials P300 with memory function in obstructive sleep apnea syndrome

目的探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者的P300指标变异情况和记忆功能状况的关系。方法对浙江大学医学院附属第一医院2008年7月至2009年12月睡眠呼吸障碍专科门诊就诊的患者，进行夜间至少7h多导睡眠监测，共纳入OSAS患者30例，其中男22例，女8例，平均年龄（42±6）岁；对照组为健康志愿者20名，其中男15名，女5名，平均年龄（40±6）岁，分别进行韦氏记忆量表评定和事件相关电位P300检查。采用t检验、卡方检验和Pearson等级相关法对各组数据进行检验及比较。结果OSAS组的记忆商评分为（86±13）分，与对照组比较有显著降低（P〈0．01）；OSAS组的P300检查显示Cz、Pz点的潜伏期分别为（410±80）ms和（409±80）ms，较对照组明显延长（P〈0．01）；Cz、Pz点的潜伏期与记忆商评分呈显著负相关（r=-0．581，-0．583，均P〈0．01），与睡眠呼吸紊乱指数呈正相关，差异有统计学意义（r=0．653，0．64，均P〈0．01）；与平均血氧及最低SaO2呈负相关，差异有统计学意义（r=-0．755，- 0．745，均P〈0．01；r=-0．67，-0．656，均P〈0．01）。结论OSAS患者存在明显的记忆功能障碍，P300潜伏期的延长可作为评估OSAS记忆功能障碍的电生理学指标之一；慢性间歇低氧可能导致与记忆相关的脑功能区域发生损伤性变化。

Objective To explore the variability of event-related potentials P300 and memory function in patients with obstructive sleep apnea syndrome （ OSAS ）. Methods Polysomnography （ PSG ） event-related potentials（ERPs） P300 and Wechsler Memory Scale （WMS） were detected in 30 subjects with OSAS and 20 normal controls. Results The memory quotient [ （86 ±13） scores] in the OSAS group was significantly lower than that in the control group （ P 〈 0. 01 ）. The latency of P300 [ （410 ±80） ms at Cz and （409 ±80） ms at Pz] in the OSAS group was significantly longer than that in the control group （P 〈0. 01）. In the OSAS group, the latency of P300 was correlated negatively with the memory quotient and nocturnal hypoxemia, but positively with apea/hypopnea index （ AHI, P 〈 0. 01 ）. Conclusion OSAS has memory deficit, which can be evaluated comprehensively by P300 and WMS. The longer latency of P300 might be regarded as one of the electrophysiological markers to indicate the severity of cognition in OSAS. Recurrent attacks of nocturnal intermittent hypoxemia may cause the regional brain damage related to cognition defect.