中重度阻塞性睡眠呼吸暂停低通气综合征患者血清促生长激素释放激素水平对认知功能的影响

Effect of serum growth hormone releasing hormone levels on cognitive function in patients with moderate-severe obstructive sleep apnea-hypopnea syndrome

目的检测阻塞性睡眠呼吸暂停低通气（OSAHS）患者血清促生长激素释放激素（GHRH）水平并评估其认知功能，探讨GHRH对OSAHS患者认知功能的影响。方法回顾性分析2013年10月至2017年5月于中国医科大学附属第一医院呼吸与危重症医学科就诊的70例中重度OSAHS患者（OSAHS组），其中男54例，女16例，年龄45～65岁，平均（53±6）岁；纳入同期本院体检的32例单纯鼾症患者（对照组），其中男16例，女16例，年龄45～65岁，平均（53±6）岁。所有受试者均行多导睡眠监测（PSG）及认知功能评估，在第2天清晨抽血，采用ELISA法检测血清GHRH水平。结果OSAHS组患者血清GHRH水平为（319±187） pg/ml，与对照组[（291±147）pg/ml]比较差异无统计学意义（P〉0.05）；但未合并认知障碍的OSAHS患者血清GHRH水平[（370±197）pg/ml]明显高于对照组，而合并认知障碍的OSAHS患者血清GHRH水平[（194±71） pg/ml]明显低于对照组（均P〈0.05）。相关性分析结果表明，中重度OSAHS患者认知功能受血清GHRH水平（OR值为0.42，95%CI：0.24～0.73）、体重指数（OR值为2.23，95%CI：1.03～4.79）及嗜睡评分（OR值为1.80，95%CI：1.04～3.09）的影响。结论中重度OSAHS患者血清GHRH水平对患者的认知功能可能起保护作用。

ObjectiveTo investigate the effect of GHRH on the cognitive function of OSAHS patients by detecting the serum GHRH levels and assessing their cognitive function in patients with OSAHS. MethodsA total of 70 moderate-severe OSAHS patientsand 32 adults with snoring from October 2013 to May 2017 were enrolled for overnight polysomnography（PSG） and cognitive function assessment. Blood samples were taken at the next morning and serum GHRH levels were measured by ELISA.ResultsThere was no significant difference between OSAHS group （318.73±186.66）pg/ml and control group （291.48±147.36）pg/ml. Compared with control group, the serum GHRH levels were significantly increased in OSAHS patients without cognitive impairment （370.31±197.33）pg/ml, and evidently decreased in those with cognitive impairment （193.63±70.97）pg/ml （both P〈0.05）. The cognitive function of OSAHS patients was influenced by serum GHRH levels （OR=0.42, 95%CI： 0.24-0.73）, body mass index （OR=2.23, 95%CI： 1.03-4.79）, and daily sleepiness score （OR=1.80, 95%CI： 1.04-3.09）.ConclusionSerum GHRH levels in patients with moderate-severe OSAHS may play a protective role in patients′ cognitive function.