目的评估心血管并发症出现前老年阻塞性睡眠呼吸暂停综合征(OSA)患者的心脏结构和功能改变及其影响因素。方法入选82名无心血管疾病的老年OSA患者,根据睡眠呼吸暂停低通气指数(AHI)分为轻度组(AHI<15次/h)和中/重度组(AHI≥15次/h)...目的评估心血管并发症出现前老年阻塞性睡眠呼吸暂停综合征(OSA)患者的心脏结构和功能改变及其影响因素。方法入选82名无心血管疾病的老年OSA患者,根据睡眠呼吸暂停低通气指数(AHI)分为轻度组(AHI<15次/h)和中/重度组(AHI≥15次/h)。记录患者人口统计学资料及一般基础资料,PSG监测结束的当天早上空腹状态下抽取静脉血,检测血常规与生化指标。在整夜多导睡眠监测完成1周内完成超声心动图检查,分析两组间心脏结构、功能及血生化指标等的差异。结果中重度OSA组患者血小板比积(0.22±0.08 vs 0.17±0.04,P=0.032)、血肌酐水平(70.94±27.88 vs 54.49±34.22,P=0.022)高于轻度OSA组。两组患者的左室射血分数、室间隔厚度、左室后壁厚度、左房内径、左室舒张末内径均无显著差别。两组二尖瓣舒张早期血流速度峰值(E)相似,但中重度OSA组的舒张晚期二尖瓣血流速度峰值(A)高于轻度OSA组(70.35±6.87 vs 64.09±8.31,P=0.0001),其E/A比值显著低于轻度OSA组(0.98±0.06 vs 1.08±0.05,P=0.0001)。多元线性回归显示,E/A比值与AHI呈负相关(β=-0.645,P=0.0001)。结论在没有高血压和任何其他心血管疾病的情况下,老年中重度OSA患者可出现心脏舒张功能受损,其程度与AHI正相关。展开更多
The present study was aimed to evaluate restingstate functional connectivity and topological properties of brain networks in narcolepsy patients compared with healthy controls.Resting-state fMRI was performed in 26 ad...The present study was aimed to evaluate restingstate functional connectivity and topological properties of brain networks in narcolepsy patients compared with healthy controls.Resting-state fMRI was performed in 26 adult narcolepsy patients and 30 matched healthy controls.MRI data were first analyzed by group independent component analysis,then a graph theoretical method was applied to evaluate the topological properties in the whole brain.Small-world network parameters and nodal topological properties were measured.Altered topological properties in brain areas between groups were selected as regionof-interest seeds,then the functional connectivity among these seeds was compared between groups.Partial correlation analysis was performed to evaluate the relationship between the severity of sleepiness and functional connectivity or topological properties in the narcolepsy patients.Twenty-one independent components out of 48 were obtained.Compared with healthy controls,the narcolepsy patients exhibited significantly decreased functional connectivity within the executive and salience networks,along with increased functional connectivity in the bilateral frontal lobes within the executive network.There were no differences in small-world network properties between patients and controls.The altered brain areas in nodal topological properties between groups were mainly in the inferior frontal cortex,basal ganglia,anterior cingulate,sensory cortex,supplementary motor cortex,and visual cortex.In the partial correlation analysis,nodal topological properties in the putamen,anterior cingulate,and sensory cortex as well as functional connectivity between these regions were correlated with the severity of sleepiness(sleep latency,REM sleep latency,and Epworth sleepiness score)among narcolepsy patients.Altered connectivity within the executive and salience networks was found in narcolepsy patients.Functional connection changes between the left frontal cortex and left caudate nucleus may be one of the parameters describing the severity of narcolepsy.Changes in the nodal topological properties in the left putamen and left posterior cingulate,changes in functional connectivity between the left supplementary motor area and right occipital as well as in functional connectivity between the left anterior cingulate gyrus and bilateral postcentral gyrus can be considered as a specific indicator for evaluating the severity of narcolepsy.展开更多
文摘目的评估心血管并发症出现前老年阻塞性睡眠呼吸暂停综合征(OSA)患者的心脏结构和功能改变及其影响因素。方法入选82名无心血管疾病的老年OSA患者,根据睡眠呼吸暂停低通气指数(AHI)分为轻度组(AHI<15次/h)和中/重度组(AHI≥15次/h)。记录患者人口统计学资料及一般基础资料,PSG监测结束的当天早上空腹状态下抽取静脉血,检测血常规与生化指标。在整夜多导睡眠监测完成1周内完成超声心动图检查,分析两组间心脏结构、功能及血生化指标等的差异。结果中重度OSA组患者血小板比积(0.22±0.08 vs 0.17±0.04,P=0.032)、血肌酐水平(70.94±27.88 vs 54.49±34.22,P=0.022)高于轻度OSA组。两组患者的左室射血分数、室间隔厚度、左室后壁厚度、左房内径、左室舒张末内径均无显著差别。两组二尖瓣舒张早期血流速度峰值(E)相似,但中重度OSA组的舒张晚期二尖瓣血流速度峰值(A)高于轻度OSA组(70.35±6.87 vs 64.09±8.31,P=0.0001),其E/A比值显著低于轻度OSA组(0.98±0.06 vs 1.08±0.05,P=0.0001)。多元线性回归显示,E/A比值与AHI呈负相关(β=-0.645,P=0.0001)。结论在没有高血压和任何其他心血管疾病的情况下,老年中重度OSA患者可出现心脏舒张功能受损,其程度与AHI正相关。
基金supported by the National Natural Science Foundation of China (81700088 and 81671765)the Key International (Regional) Cooperation Program of the National Natural Science Foundation of China (81420108002)+1 种基金the National Basic Research Development Program (973 Program) of China (2015CB856405)the Beijing Municipal Natural Science Foundation (7172121)
文摘The present study was aimed to evaluate restingstate functional connectivity and topological properties of brain networks in narcolepsy patients compared with healthy controls.Resting-state fMRI was performed in 26 adult narcolepsy patients and 30 matched healthy controls.MRI data were first analyzed by group independent component analysis,then a graph theoretical method was applied to evaluate the topological properties in the whole brain.Small-world network parameters and nodal topological properties were measured.Altered topological properties in brain areas between groups were selected as regionof-interest seeds,then the functional connectivity among these seeds was compared between groups.Partial correlation analysis was performed to evaluate the relationship between the severity of sleepiness and functional connectivity or topological properties in the narcolepsy patients.Twenty-one independent components out of 48 were obtained.Compared with healthy controls,the narcolepsy patients exhibited significantly decreased functional connectivity within the executive and salience networks,along with increased functional connectivity in the bilateral frontal lobes within the executive network.There were no differences in small-world network properties between patients and controls.The altered brain areas in nodal topological properties between groups were mainly in the inferior frontal cortex,basal ganglia,anterior cingulate,sensory cortex,supplementary motor cortex,and visual cortex.In the partial correlation analysis,nodal topological properties in the putamen,anterior cingulate,and sensory cortex as well as functional connectivity between these regions were correlated with the severity of sleepiness(sleep latency,REM sleep latency,and Epworth sleepiness score)among narcolepsy patients.Altered connectivity within the executive and salience networks was found in narcolepsy patients.Functional connection changes between the left frontal cortex and left caudate nucleus may be one of the parameters describing the severity of narcolepsy.Changes in the nodal topological properties in the left putamen and left posterior cingulate,changes in functional connectivity between the left supplementary motor area and right occipital as well as in functional connectivity between the left anterior cingulate gyrus and bilateral postcentral gyrus can be considered as a specific indicator for evaluating the severity of narcolepsy.
