阻塞性睡眠呼吸暂停低通气综合征对患者认知功能的影响及其机制

Effect of obstructive sleep apnea hypopnea syndrome on cognitive function and its mechanism

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对患者认识功能障碍的影响及其机制。方法将我院119例OSAHS患者分为轻度组28例,中度组21例,重度组70例;同时,选取同时期55例单纯鼾症患者为对照组。比较四组患者的Mo CA及MMSE评分,并分析OSAHS各组患者中睡眠结构参数及低氧参数对认知功能的影响。结果重度组患者的Mo CA与MMSE总评分明显低于对照组、轻度组及中度组(P<0.05)。四组患者睡眠结构参数及低氧参数各指标水平比较,差异显著(P<0.05)。Ⅲ%和Sa O2与Mo CA评分呈正相关(P<0.05),(Ⅰ+Ⅱ)%和AHI与Mo CA评分呈负相关(P<0.05);AHI与MMSE评分呈负相关(P<0.05);Sa O2与MMSE评分呈正相关(P<0.05)。结论 OSAHS对患者的认知功能有一定损害,Mo CA可以作为筛查OSAHS患者认知障碍的方法。低氧、睡眠结构紊乱等是造成OSAHS患者认知功能减退的可能机制。

Objective To explore the effect of obstructive sleep apnea hypopnea syndrome （OSAHS） on cognitive functionand its mechanism. Methods A total of 119 OSAHS patients were divided into mild group （n=28）, moderate group （n=21） andsevere group （n=70）, and 55 cases of snoring patients were enrolled as the control group. The MoCA and MMSE scores andeffect of OSAHS on cognitive function were analyzed among the four groups. Results The total MoCA and MMSE scores of thesevere group were lower than those in the mild group, moderate group and control group （P〈0.05）. There were significantdifferences among the four groups in levels of sleep structure parameters and hypoxic parameters（P〈0.05）. There was a positivecorrelation between芋%, SaO2 and MoCA scores（P〈0.05）;（玉＋域）% and AHI were negatively correlated with MoCA scores（P〈0.05）. AHI was negatively correlated, and SaO2 was positively correlated with MMSE scores （P〈0.05）. Conclusion OSAHSis harmful to the cognitive function of the patients, and the MoCA can be used as a method for screening cognitive disorders.Hypoxia and sleep disorder are the possible mechanisms of cognitive impairment in patients with OSAHS.