OSAHS患者HCY、SAA水平与认知功能的关系研究

Correlations of serum homocysteine and amyloid protein A levels with cognitive function in patients with obstructive sleep apnea hypopnea syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者同型半胱氨酸(HCY)、淀粉样蛋白A(SAA)水平与认知功能的关系。方法测定62例OSAHS患者及同期37例健康体检者(对照组)的HCY、SAA水平,并依据蒙特利尔认知评估量表(Mo CA)进行评分,分析HCY、SAA与认知结果的相关性。结果 1OSAHS患者HCY、SAA水平[分别为(13.60±3.00)和(105.32±34.63)μmol/L]高于对照组[(11.21±1.10)和(44.72±48.3)μmol/L],差异有统计学意义,其Mo CA总分及立方体构图、画钟试验、目标数字识别、延迟回忆亚项评分低于对照组,差异有统计学意义(P<0.05);2OSAHS组SAA、HCY水平与Mo CA总分呈负相关(rHCY=-0.475,rSAA=-0.767,P=0.000);3OSAHS患者合并轻度认知障碍,HCY、SAA[分别为(12.99±2.90)和(85.19±50.08)μmol/L]水平较正常认知组[分别为(11.56±0.70)和(52.12±10.40)μmol/L]升高,差异有统计学意义(P<0.05);4受试者工作特征曲线分析OSAHS患者认知功能障碍的HCY、SAA曲线下面积分别为0.77和0.72。结论HCY、SAA是OSAHS患者认知功能障碍形成的影响因素,其水平与认知损害程度呈负相关。

Objective To investigate the correlations of serum homocysteine （HCY） and serum amyloid protein A （SAA） levels with cognitive function in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Sixty-two patients with OSAHS and thirty-seven controls were recruited. HCY and SAA levels were determined by ELISA. Cognitive function was measured by Montreal Cognitive Assessment. HCY, SAA and the score of MoCA were compared between the two groups. The receiver operating characteristic （ROC） curve was drawn. Results The serum levels of HCY and SAA in the OSAHS patients [（13.60 ± 3.00） μmol/L and （105.32 ± 34.63）μmol/L, respectively] were significantly higher than those in the healthy control group [（11.21 ± 1.10）μmol/L and （44.72±48.3） μmol/L, respectively], the total score of MoCA and the score of each item were significantly lower than those of the control group （P〈 0.01）. HCY level and SAA level were negatively correlated with the total score of MoCA （rHCY-1 = -0.475 and r SAA=-0.767 respectively, P〈 0.05）. The levels of HCY and SAA in the OSAHS patients with mild cognitive impairment （MCI） [（12.99 ± 2.90）μmol/L and （85.19 ± 50.08）μmol/L, respectively] were significantly higher than those in the patients without MCI [（11.56 ± 0.70）μmol/L and （52.12 ± 10.40） μmol/L, respectively]. For cognitive dysfunction in the OSAHS patients, the areas under ROC curve of HCY and SAA were 0.77 and 0.72. Conclusions Serum HCY and SAA levels are the influencing factors of cognitive impairment in patients with OSAHS, and the levels of HCY and SAA are, negatively correlated with the degree of cognitive impairment.