NO/ET-1比值及Hcy水平与OSAHS患者认知功能障碍的相关性分析

Effect of NO/ET-1 and Hcy on cognitive impairment in OSAHS patients

目的探讨血清同型半胱氨酸(Hcy)和一氧化氮NO与内皮素-1(ET-1)比值对阻塞型睡眠呼吸暂停低通气综合征(OSAHS)患者认知功能障碍的诊断效能,为干预OSAHS患者并发认知功能障碍提供新的临床依据。方法选取OSAHS患者86例(OSAHS组)及健康体检者50例(对照组)。OSAHS组患者又分为认知障碍组和认识正常组。比较两组血清Hcy及NO/ET-1水平,应用蒙特利尔认知评估量表(MoCA)评估OSAHS组轻度认知功能障碍发生情况,分析OSAHS组患者血清Hcy、NO/ET-1水平与认知功能的相关性。结果 OSAHS伴认知障碍患者血清Hcy水平高于认知正常组,NO/ET-1水平低于认知正常组(P<0.05)。OSAHS认知障碍组呼吸暂停低通气指数(AHI)、睡眠时间高于认知正常组,最低动脉血氧饱和度(LSaO2)低于认知正常组(P<0.05)。MoCA评分与AHI、睡眠时间呈负相关,与LSaO2呈正相关。血清Hcy水平与MoCA总分及其亚项得分均呈负相关(P<0.05),NO/ET-1与MoCA总分及其亚项评分均呈正相关(P<0.05),Hcy与NO/ET-1呈负相关(P<0.05)。血清Hcy及NO/ET-1水平预测OSAHS患者认知功能障碍的ROC曲线下面积分别为0.708(95%CI:0.599,0.816)、0.739(95%CI:0.618,0.859)。结论血清Hcy、NO/ET-1是OSAHS患者认知功能障碍形成的影响因素,Hcy水平与认知损害程度呈负相关,NO/ET-1与认知损害程度呈正相关。

Objective To investigate the effect of Hcy and NO/ET-1 on cognitive dysfunction in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Totally 86 patients with OSAHS (OSAHS group) and 50 healthy controls (control group) were selected. The levels of serum Hcy and ratio of NO/ET-1 were determined. The Montreal cognitive assessment scale was used to evaluate the incidence of mild cognitive impairment. Correlation between the level of serum Hcy or NO/ET-1 and cognitive function was analyzed. Results The level of serum Hcy in patients with OSAHS was increased while NO/ET-1 was decreased when compared with those in normal control group (P < 0.05). The AHI and sleep time in OSAHS group were higher while LSaO2 was lower significantly compared with those in normal group (P < 0.05). MoCA score was negatively correlated with AHI, sleep time and serum Hcy (P < 0.05). MoCA score was positively correlated with LSaO2 and NO/ET-1 (P < 0.05). Cut-off point of ROC curve of serum Hcy and NO/ET-1 for prediction of cognitive impairment in COPD patients were 0.708 (95% CI: 0.599, 0.816) and 0.739 (95% CI: 0.618, 0.859), respectively. Conclusions Serum Hcy and NO/ET-1 may be independent prognostic factors for cognitive impairment in OSAHS patients.