阻塞性睡眠呼吸暂停低通气综合征老年患者神经营养因子水平与认知功能的相关性

Correlation between neurotrophic factor in obstructive sleep apnea hypopnea syndrome in the elder with cognitive function

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清神经营养因子水平的变化及其与认知功能间的相关性。方法按顺序纳入该院2013年5月至2014年9月收治的患者77例,参照呼吸暂停低通气指数(AHI)标准分为轻度OSAHS组25例、中度OSAHS组25例和重度OSAHS组27例;同时选择25例体检者作为健康对照组;分别进行多导睡眠图(PSG)监测;采用蒙特利尔认知评估量表(Mo CA)和简易智能状态量表(MMSE)对各组的认知功能进行评价;并检测血清神经生长因子(NGF),脑源性神经营养因子(BDNF),胶质细胞源性神经营养因子(GDNF)和睫状神经营养因子(CNTF)水平。分析以上参数间的相关性。结果与对照组比较,轻、中和重度OSAHS组患者的AHI、氧减指数(ODI)、呼吸相关微觉醒指数(RI)和脉氧饱和度低于90%的时间占总睡眠时间的百分比(TS90%)均明显升高(P<0.01),且重度组较轻和中度组升高更明显(P<0.01);而重度组患者的最低脉氧饱和度(LSa O2)和平均脉氧饱和度(MSa O2)较对照组明显降低(P<0.01);与对照组比较,重度OSAHS组患者的Mo CA、MMSE评分显著降低(P<0.01);与轻、中度OSAHS组相比,重度OSAHS组MoCA评分显著降低(P<0.01)。与对照组比较,轻、中和重度OSAHS组患者血清神经营养因子水平均减少;而重度OSAHS组患者血清营养因子较对照组、轻和中度OSAHS组患者明显减少,比较差异有统计学意义(P<0.01)。血清营养因子水平与睡眠呼吸记录指标AHI、ODI、RI和TS90%呈负相关,而与最低Sa O2和平均Sa O2呈正相关。血清营养因子水平与认知功能指标Mo CA和MMSE均呈正相关。结论血清神经营养因子水平是反映OSAHS患者的重要指标,且与其认知功能障碍密切相关。

Objective To study the correlation between neurotrophic factor in obstructive sleep apnea hypopnea syndrome （OSAHS） in the elder with cognitive function.Methods Patients with OSAHS and healthy people were enrolled for study.The neurotrophic fac-tor（NGF）,brain-derived neurotrophic factor（BDNF）,glial cell line-derived neurotrophic factor （GDNF）and ciliary neurotrophic fac-tor （CNTF）were detected.The cognitive function was evaluated with MoCA and MMSE.The correlation between NGF,BDNF,GD-NF and CNTF with cognitive function was analyzed.Results Compared with the control group,mild,moderate and severe OSAHS pa-tients of AHI,oxygen desaturation index （ODI）,the percentage of time breathing-related arousal index （RI）and pulse oxygen satura-tion less than 90% of total sleep time （TS 90%）were significantly higher （P 〈0.01）.The NGF in the severe OSAHS patients was significantly lower than in control group,mild and moderate OSAHS patients.The NGF correlated negatively with AHI,ODI,RI and TS 90%,while positively with MoCA and MMSE.Conclusions Serum NGF levels are an important indicator for patients with OSAHS and correlates closely with cognitive function.