阻塞性睡眠呼吸暂停低通气综合征对缺血性脑血管病危险因素及认知功能的影响

摘要

Objective To investigate the influence of obstructive sleep apnea hypopnea syndrome (OSAHS) on risk factors and cognitive function of patients with ischemic cerebrovascular disease (ICD). Methods Ninety-five ICD or OSAHS patients were divided into three groups based on polysomnography results: combined(ICD combined with OSAHS) group, 40 persons; ICD group,35 persons;OSAHS group, 20 persons. All patients were tested by Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment (MoCA). Risk factors of ICD were analysed.Results The proportion of hypertension,the proportion of alcohol drinking and BMI in combined group were higher than those in ICD group (P ＜ 0. 05). The scores of MMSE, MoCA,executive function and delayed recall in combined group were significantly lower than those in ICD group or OSAHS group (P ＜ 0. 01). The ability of orientation, language and intelligence in combined group were significantly lower than those in OSAHS group. The scores of MMSE and MoCA in OSAHS group were negatively correlated with AHI (r =-0. 371 ;r =-0. 547,P＜ 0.05) and oxygen decrease index (r =- 0. 541 ;r =- 0. 594,P ＜ 0.01) ,while positively correlated with night average oxygen saturation (r =- 0. 404;r = 0. 453,P ＜ 0.05). Conclusion OSAHS may have influence on risk factors and cognitive function of patients with ICD.%目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对缺血性脑血管病危险因素及认知功能的影响.方法 入选缺血性脑血管病及OSAHS患者95例,根据诊断将患者分为缺血性脑血管病合并OSAHS组(合并组)40例,缺血性脑血管病不伴OSAHS组(脑血管病组)35例,单纯OSAHS组(OSAHS组)20例,3组均进行简易智能状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)测定.结果 合并组合并高血压、饮酒比例及体重指数高于脑血管病组(P＜0.05);MMSE、MoCA评分、执行功能和延迟记忆评分显著低于脑血管病组和OSAHS组(P＜0.01);定向力、语言能力和积木试验评分低于OSAHS组(P＜0.05).OSAHS组患者MMSE和MoCA评分与呼吸暂停低通气指数(γ=-0.371、-0.547,P＜0.05)、氧减指数(γ=-0.541、-0.594,P＜0.01)呈负相关,与夜间平均SaO2(γ=0.404、0.453,P＜0.05)呈正相关.结论 OSAHS加重缺血性脑血管病的危险因素和认知功能障碍.