男性重度阻塞性睡眠呼吸暂停低通气综合征患者认知功能的损害

摘要

Objective To investigate the change of cognitive function in male patients with obstructive sleep apnea and hypopnea syndrome(OSAHS) using neuropsychological scales. Methods 152 male patients with OSAHS were collected from the First Affiliated Hospital of China Medical University, they were divided into three groups according to apnea-hypopnea index (AHI), including mild group(n=56), moderate group(n=36)and severe group(n=60). They were assessed by Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results The total scores of MoCA and MMSE decreased significantly in the severe (24.6±52.943, 26.63±2.687) male group than those in the mile(26.27±2.875, 28.07±2.271) and moderate (26.28±2.525, 27.94±2.042) groups(P<0.05, P<0.05). The total scores of MoCA in memory and delayed recall, attention decreased significantly in the severe (2.37±1.33, 5.08±1.06) than those in the mile(2.95±1.51, 5.63±0.66) and moderate (2.91±1.39, 5.58±0.91) groups. The total scores of MoCA and MMSE were negatively related to age, smoking index, alcohol consumption, AHI, HI, OAI, SLT90%and positively related to SaO2 min, SaO2 ave and years of education. Conclusion Compared with the mild, moderate male OSAHS patients, cognitive function declined significantly in severe male OSAHS patients, mainly perform in memory and delayed memory, attention. The total scores of MoCA and MMSE were closely related to the patient's age, years of education, smoking and drinking habits and PSG indexes.%目的：评估重度男性阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者认知功能损害情况。方法选择中国医科大学附属第一医院经多导睡眠仪监测确诊的152例OSAHS男性患者，记录患者一般资料。进行简易智能精神状态检查量表（MMSE）、蒙特利尔认知评估中文版（MoCA）检查。根据睡眠呼吸暂停低通气指数（AHI）将患者分为轻（n＝56）、中（n＝36）、重（n＝60）三组。结果重度男性OSAHS患者MMSE总分（26.63±2.687）明显低于轻度（28.07±2.271）、中度（27.94±2.042）OSAHS患者组，差异有统计学意义（ P 均＜0.05）；重度男性 OSAHS 患者 MoCA 总分（24.65±2.943）明显低于轻（26.27±2.875）、中度（26.28±2.525）组，差异有统计学意义（P 均＜0.05）；重度组记忆和延迟回忆（2.37±1.33）、注意（5.08±1.06）得分明显低于轻度组（2.95±1.51；5.63±0.66）以及中度组（2.91±1.39；5.58±0.91），差异有统计学意义（P均＜0.05）；男性OSAHS患者的MMSE总分、MoCA总分分别与年龄、吸烟指数、累计饮酒量、AHI指数、低通气指数（HI）、暂停指数（AI）、夜间血氧饱和度低于90%时间占总睡眠时间百分比（SLT90%）呈负相关，与受教育年限、夜间最低血氧饱和度（SaO2 min）、夜间平均血氧饱和度（SaO2 ave）呈正相关。结论重度男性 OSAHS 患者较轻、中度 OSAHS 男性患者认知功能明显下降，主要表现在记忆和延迟记忆、注意等方面的损害；MoCA、MMSE 总分与患者的吸烟、饮酒习惯以及PSG检测结果密切相关。