阻塞性睡眠呼吸暂停与轻度认知损伤的相关性研究

Study of cognitive impairment in elderly patients with obstructive sleep apnea

目的探讨老年阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)人群缺氧程度与轻度认知功能损伤的相关性。方法收集2015年2月至2016年8月于解放军第306医院呼吸科就诊的老年OSA病人共338例,年龄60~87岁;根据老年人群呼吸暂停低通气指数(AHI)分成轻度组128例,中度组107例和重度组103例;使用蒙特利尔认知功能量表(Montreal cognitive assessment,Mo CA)评估认知功能。结果 3组间男性比例、BMI、饮酒量、糖尿病以及冠心病比例差异均有统计学意义(P<0.05);在认知功能方面,中度和重度组老年OSA病人存在轻度认知功能损伤,且与轻度组相比,Mo CA总分差异有统计学意义(P<0.05)。多元Logistic回归结果显示,相比轻度OSA组,重度组患有轻度认知损伤的风险增加13倍(P<0.05)。结论老年OSA病人常常合并有认知功能损伤,并且病情越重,认知损伤越显著。

Objective To explore the association of obstructive sleep apnea（ OSA） with mild cognitive impairment（ MCI） in the elderly patients. Methods A total of 338 elderly patients aged 60-87 years old who admitted into Department of Respiration of the 306 Hospital of P LA during Feburary 2015 to August 2016 were included in our study. All patients were then classified into three OSA groups according to their AHI score： mild OSA group（ n = 128）,moderate OSA group（ n =107）,and severe OSA group（ n = 103）. The cognitive function of each patient was assessed by Montreal cognitive assessment（ MoCA）. Results Overall,the proportion of male gender,BMI value,alcohol intake,diabetes and coronary heart disease prevalence were statistically different（ P 〈0. 05） among the three OSA groups; The patients in the moderate and severe OSA groups had MCI.The scores of Mo CA in the moderate and severe OSA groups were significantly lower than that of the mild OSA group. The multiple Logistic regression showed that the severe OSA group had 13-fold more risk of MCI compared to the mild OSA group. Conclusions Elderly OSA patients usually suffer from cognitive dysfunction,and the degree of cognitive impairment is significantly associated with the severity of OSA.