老年阻塞性睡眠呼吸暂停低通气综合征并发急性脑出血病人执行功能障碍与血清ET-1的相关性分析

Correlation between Executive Dysfunction and Serum Endothelin-1 in Elderly Patients with Obstructive Sleep Apnea Hypopnea Syndrome Complicated with Acute Intracerebral Hemorrhage

目的分析老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并发急性脑出血病人执行功能障碍与血清内皮素-1(ET-1)的相关性。方法以264例OSAHS并发脑出血病人为研究对象,根据执行缺陷综合征的行为学评价测试(BADS)结果分为无执行功能障碍组和有执行功能障碍组,对两组病人年龄、性别、体重指数、受教育年限、出血部位、出血量、有无慢性病、OSAHS程度以及ET-1等执行功能障碍的潜在因素进行单因素和多因素分析;分析血清ET-1与执行功能障碍的相关性。结果 ET-1水平升高是老年OSAHS并发急性脑出血病人执行功能障碍的影响因素;高ET-1水平病人比非高ET-1水平病人发生执行功能障碍的风险显著增加[χ2=13.33,P=0.000,RR=1.913,95%CI(1.592,6.096)];Pearson相关分析显示,ET-1水平与BADS各项评分及总评分呈负相关,差异有统计学意义(P<0.01)。结论 ET-1水平升高是老年OSAHS并发急性脑出血病人执行功能障碍的独立危险因素,ET-1水平与执行功能障碍程度有关。

Objective To investigate the correlation between executive dysfunction and serum endothelin-1 （ET-1） in elderly patients with obstructive sleep apnea hypopnea syndrome （ OSAHS） complicated with acute intracerebral hemorrhage. Methods Two hundreds and sixty-four elderly patients of OSAHS complicated with acute intracerebral hemorrhage were chosen as observed ob-jects,and they were divided into non-executive function impairment group and executive function impairment group according to the assess of behavioral assessment of dysexecutive syndrome （BADS）.Univariate and multiple analysis were conducted in the potential impacting factors of executive function impairment including age,gender,the level of education,Body Mass Index （BMI）,bleeding site,a-mount of bleeding,OSAHS degree,combined other chronic diseases and serum ET-1 between two groups.Pearson analysis was con-ducted to analyze the correlation between executive dysfunction with serum ET-1.Results Serum ET-1 was independent impac-ting factors of executive dysfunction after acute intracerebral hemorrhage in elderly patients with OSAHS.The risk of executive dys-function was significantly increased in patients with high level of serum ET-1 than that in patients with normal level[χ2=13.33, P=0.000,RR=1.913,95% CI （1.592,6.096）].Pearson correlation analysis showed that serum ET-1 levels were negatively correlated with BADS scores （ P〈0.01）.Conclusion Elevated blood ET-1 level is an independent risk factor for executive dysfunction after acute intracerebral hemorrhage in elderly patients with OSAHS.The level of serum ET-1 is related to the degree of executive dysfunction.