摘要
目的 探讨阻塞性睡眠呼吸暂停综合征患者 (OSAS)认知障碍的生化机制。方法 对OSAS组 36例 ,对照组 18例进行睡眠多导仪和神经心理测验量表检查 ,用放射免疫方法检测血清胰岛素样生长因子 1(IGF I)水平 ,观察患者血清IGF I变化 ,并比较它与认知功能、夜间低氧和睡眠结构紊乱间的关系。结果 OSAS患者视觉再生 (用于检测短时记忆能力 )和数字符号 (用于检测一般学习能力 )两项神经心理测验分数明显低于对照组 (视觉再生 :患者为 8 4± 2 7;对照为 11 6± 1 4 ;P <0 0 1;数字符号 :患者为 36 9± 8 3;对照为 4 7 8± 6 8,P <0 0 1) ,血清IGF I水平显著降低 (患者为12 7 2± 87 0 ;对照为 194 0± 77 3;P <0 0 5 ) ,且与视觉再生 (r=0 381,P <0 0 5 )和数字符号 (r =0 330 ,P <0 0 5 )两项受损神经心理测验分数呈正相关 ,与最低血氧饱和度 (r=0 371,P <0 0 5 )、平均血氧饱和度 (r=0 333,P <0 0 5 )和REM睡眠长短 (r=0 5 98,P <0 0 1)呈正相关。结论 OSAS患者短时记忆能力和一般学习能力受损 ,血清IGF I水平降低 ,且可能是其认知功能障碍的生化机制之一。夜间低氧和REM期睡眠剥夺可能是导致血清IGF I降低的原因。
Objective To explore the possible biochemical mechanism of cognitive impairment in patients with obstructive sleep apnea syndrome (OSAS) Methods Polysomnography was administered to thirty six patients with OSAS and eighteen education and BMI matched controls, all males aged 40～49 for 8 5 hours at night Early next morning blood was drawn and serum insulin like growth factor I (IGF I) was determined by immunoradiometric assay Then neuropsychological tests of visual regeneration, digital symbol, comprehensive memory and digital span were conducted Results The quality of sleep in the patients with OSAS was significantly worse than that of the controls The score of visual regeneration in the patients with OSAS was 8 4±2 7, significantly lower than that in control group (11 6±1 4, P <0 01) The score of digital symbol in patients with OSAS was 36 92±8 31, significantly lower than that in the controls (47 8±6 8, P <0 01) The serum IGF I level of the patients with OSAS was: 127 2±87 0 ng/ml, significantly lower than that of the controls (194 03 ng/ml±77 31 ng/ml, P <0 05) The IGF I level was significantly positively correlated with the scores of visual regeneration test ( r =0 381, P <0 05) and digital symbol test ( r =0 330, P <0 05), lowest SaO 2 ( r =0 371, P <0 05), mean SaO 2 ( r =0 333, P <0 05) and REM sleep duration ( r =0 598, P <0 01). Conclusion Decrease of serum IGF I level may play a role in the cognitive impairment in patients with OSAS Nocturnal hypoxemia and REM sleep deprivation may be the reason of the decrease of the serum IGF I level in patients with OSAS
出处
《中华医学杂志》
CAS
CSCD
北大核心
2002年第20期1388-1390,共3页
National Medical Journal of China
