慢性阻塞性肺疾病不同临床表型患者认知功能障碍情况及血清Caspase-3及Caspase-9水平变化

Cognitive function impairment and the changes of serum Caspase-3 and Caspase-9 levels in chronic obstructive pulmonary disease patients with different clinical phenotypes

目的探讨不同临床表型慢性阻塞性肺疾病(COPD)患者认知功能障碍情况及血清半胱氨酸天冬酶-3(Caspase-3)及半胱氨酸天冬酶-9(Caspase-9)水平变化。方法选取COPD患者401例,根据睡眠监测检测是否存在阻塞性睡眠呼吸暂停(OSAHS),分为COPD伴OSAHS和单纯COPD两种不同临床表型,所有患者均接受应用蒙特利尔(MoCA)量表进行认知领域评估,同时检测血清Caspase-3及Caspase-9,探讨两种不同临床表型患者在MoCA得分、血清Caspase-3及Caspase-9水平的差异及COPD伴OSAHS患者存在认知障碍与否两组患者血清Caspase-3及Caspase-9水平的差异。结果与单纯COPD患者相比,COPD伴OSAHS这一临床表型患者,MoCA得分明显降低,血清Caspase-3及Caspase-9水平明显增高,COPD伴OSAHS存在认知功能障碍患者血清Caspase-3及Caspase-9水平较不伴认知功能障碍患者明显增高,差异有统计学意义(P <0.05)。结论 COPD伴OSAHS临床表型患者认知功能障碍损伤更为严重,血清Caspase-3及Caspase-9水平与认知障碍损伤相关。

Objective To investigate the cognitive function impairment and the changes of serum Caspase-3 andCaspase-9 levels in chronic obstructive pulmonary disease （COPD） patients with different clinical phenotypes.MethodsAccording to sleep monitoring results, 401 cases of COPD patients were divided into two different clinical phenotypes（COPD with OSAHS group and COPD group）.All patients were administered Montreal （MoCA） scale to assess theircognitive conditions and given detection of serum Caspase-3 and Caspase-9.The changes of cognitive function andserum Caspase-3 and Caspase-9 levels in COPD patients with different clinical phenotypes were compared.WhetherCOPD patients with OSAHS had cognitive impairment was investigated and the difference of serum Caspase-3 andCaspase-9 between the two groups were compared.Results Compared with patients in the COPD group, the MoCAscore of the COPD with OSAHS group decreased significantly while the level of Caspase-3 and Caspase-9 significant-ly increased.The level of Caspase-3 and Caspase-9 in the COPD with OSAHS group with cognitive impairment werehigher than those without cognitive impairment（P 〈0.05）.Conclusion The cognitive impairment of COPD with OS-AHS was more severe and serum Caspase-3 and Caspase-9 levels were associated with their cognitive impairment.