摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并脑梗死患者认知功能障碍的危险因素。方法选择OSAHS合并脑梗死患者328例,依据简易智能状态检查量表评分分为认知障碍组158例和认知正常组170例,多因素非条件logistic回归及分层分析OSAHS合并脑梗死患者认知功能障碍的相关危险因素。结果认知障碍组与认知正常组在血糖血脂异常、呼吸暂停低通气指数(AHI)、最低血氧饱和度、脑梗死体积、脑梗死部位、低氧诱导因子1(HIF-1)、脑红蛋白(Ngb)等方面比较,差异有统计学意义(P<0.01)。多因素logistic回归分析显示,血糖血脂异常(OR=3.527,95%CI:1.559~7.983,P=0.002)、AHI(OR=6.413,95%CI:2.766~14.865,P=0.000)、脑梗死部位(OR=4.099,95%CI:1.694~9.918,P=0.002)、HIF-1(OR=4.484,95%CI:1.950~10.310,P=0.000)、Ngb(OR=3.891,95%CI:1.759~8.606,P=0.001)是认知功能障碍的独立危险因素。进一步分层分析,分别在AHI>20次/h、脑梗死位于额颞部、合并血糖血脂异常患者中,高水平HIF-1和Ngb与认知功能障碍呈正相关。结论高水平HIF-1、Ngb与OSAHS合并脑梗死认知障碍独立相关。
Objective To study the risk factors for cognitive impaurment in obstructive sleep apnea-hypopnea syndrome（OSAHS）patients with ischemic stroke.Methods Three hundred and twenty-eight OSAHS patients with ischemic stroke were divided into cognitive impairment group（n=158）and cognitive impairment-free group（n=170）according to their MMSE score.The risk factors for their cognitive impairment were analyzed by multivariate logistic regression analysis and stratification analysis respectively.Results The blood glucose and lipid,AHI,LSaO_2,infarction size and site,HIF-1and Ngb level were significantly different between the two groups（P0.01）.Multivariate logistic regression analysis showed that blood glucose and lipid,AHI,infarction site and Ngb level were the independent risk factors for cognitive impairment（OR=3.527,95%CI：1.559-7.983,P=0.002;OR=6.413,95%CI：2.766-14.865,P=0.000;OR=4.099,95%CI：1.694-9.918,P=0.002;OR=4.484,95%CI：1.950-10.310,P=0.000;OR=3.891,95%CI：1.759-8.606,P=0.001）.Stratification analysis showed that high HIF-1and Ngb levels were positively related with cognitive impairment in patients with AHI20times/h,frontotemporal infarction,hyperglycosemia or hypoglycosemia,and dyslipidemia.Conclusion High HIF-1and Ngb levels are independently related with cognitive impairment in OSAHS patients with ischemic stroke.
作者
张馨
赵雅宁
ZHANG Xin ZHAO Ya-ning(North China University of Science and Technology Nursing and Rehabilitation School, Tangshan 063000, Hebei Province, Chin)
出处
《中华老年心脑血管病杂志》
CAS
2017年第2期167-170,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
