不同程度的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

The influence of different degrees of obstructive sleep apnea hypopnea syndrome associated on cognitivefunction

目的探讨不同程度的OSAHS对患者认知功能的影响。方法收集经我科多导睡眠监测确诊的符合OSAHS诊断标准的住院患者86例，依睡眠呼吸暂停低通气指数（AHI）分为轻中度及重度2组，比较两组蒙特利尔认知评估量表（MoCA）结果、事件相关电位（ERP）中的成分P300潜伏期、颅脑MRI常规序列及垂直于双侧海马的液体衰减反转恢复（FIAIR）序列测量所得的大脑海马萎缩体积及脑白质病变相关的侧脑室周围高信号灶（PVH）的严重程度。结果重度OSAHS患者MoCA总分明显低于轻中度，在记忆力、注意力、执行功能方面较轻中度差异有统计学意义（P〈0．05），其余认知领域的变化差异无统计学意义（P〉0．05）；重度OSAHS患者P300潜伏期明显长于轻中度组，差异有统计学意义（P〈0．05）；随着OSAHS严重程度的加重，海马体积萎缩程度及PVH均呈升高趋势，与轻中度组相比，重度OSAHS患者海马体积萎缩程度及PVH评分升高，差异有统计学意义（P〈0．05）。结论重度0sAHs患者的认知功能较轻中度组明显下降，主要表现在认知域中的记忆力、注意力、执行功能方面，同时其相应颅脑结构及功能均受累，可为诊断OSAHS患者的认识功能障碍提供早期、客观依据。

Objective To explore the influence of different degrees of obstructive sleep apnea hypopnea syndrome （OSAHS） associated on cognitive function. Methods 86 hospitailized patients with OSAHS diagnosis standard by our department polysomnography were collected. According to apnea hypopnea index （AHI）, they were divided into the mild-moderate and severe groups. And then we compared two groups of Montreal cognitive assessment scale （MoCA） results, event related potential （ERP） ingredients in P300 latency period, the brain volume of hippocampal atrophy and cerebral white matter lesions related focal high signal around the lateral ventricle which measured by regular craniocerebral MRI sequence and perpendicular to the bilateral hippocampal fluid attenuated inversion recovery （FIAIR） sequence. Results The MoCA total score of the severe group was significantly lower than the moderate groupr and so did the scores of in memoryr attentionp executiontability （ P d0.05）, but there was no significant difference in the rest of cognitive field. The P300 latency period of the severe group was significantly longer than the moderate group （ P 〈 0.05）. With the severity of OSAHS aggravated, hippocampal volume atrophy and PVH showed a trend of increase, the severe group was significantly higher than the moderate group （ P d0.05）. Conclusions Compared with moderate patients＇ the cognitive function of severe patients with OSAHS which is mainly reflected in the memoryt attentionr executiontability, and its corresponding brain structure and function are affected at the same time, its canprovide early and objective basis for OSAHSr cognitive impairment diagnosis.