摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者合并认知障碍的影响因素及尿液阿尔茨海默病相关神经丝蛋白(AD7c-NTP)水平对其诊断价值。方法选择2019年6—12月就诊于首都医科大学宣武医院呼吸与危重症医学科并经多导睡眠图(PSG)监测确诊为OSAHS的患者116例。根据蒙特利尔认知评估(MoCA)量表评分,将患者分为认知正常组80例(MoCA量表评分≥26分)和认知障碍组36例(MoCA量表评分<26分)。选取同期以打鼾为主诉就诊于首都医科大学宣武医院呼吸与危重症医学科并经PSG监测排除OSAHS的正常成年人32例作为对照组。收集受试者一般资料、PSG监测指标、MoCA量表评分、尿液AD7c-NTP水平。OSAHS患者尿液AD7c-NTP水平与MoCA量表评分的相关性分析采用Spearman秩相关分析;采用多因素Logistic回归分析探讨OSAHS患者合并认知障碍的影响因素;采用ROC曲线分析尿液AD7c-NTP水平对OSAHS患者合并认知障碍的诊断价值。结果认知正常组BMI、呼吸暂停低通气指数(AHI)、睡眠时血氧饱和度<90%的时间占睡眠总时间的百分比(SLT90%)、氧减指数(ODI)高于对照组,最长呼吸暂停时间(LAT)长于对照组,睡眠时最低血氧饱和度(LSaO_(2))、快速眼动睡眠期睡眠时间占总睡眠时间的百分比(REM%)低于对照组(P<0.05);认知障碍组年龄、BMI、AHI、SLT90%、ODI、尿液AD7c-NTP水平高于对照组,LAT长于对照组,LSaO_(2)、REM%低于对照组(P<0.05);认知障碍组BMI、AHI、SLT90%、ODI、Ⅰ+Ⅱ期睡眠时间占总睡眠时间的百分比(Ⅰ+Ⅱ%)、尿液AD7c-NTP水平高于认知正常组,LAT长于认知正常组,LSaO_(2)、Ⅲ期睡眠时间占总睡眠时间的百分比(Ⅲ%)低于认知正常组(P<0.05)。Spearman秩相关分析结果显示,OSAHS患者尿液AD7c-NTP水平与MoCA量表评分呈负相关(r_(s)=-0.461,P<0.001)。多因素Logistic回归分析结果显示,ODI〔OR=1.03,95%CI(1.01,1.04)〕、Ⅲ%〔OR=0.97,95%CI(0.95,1.00)〕及尿液
Objective To investigate the influencing factors and diagnostic value of urine Alzheimer's disease-associated neurofilament protein(AD7c-NTP)for cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 116 patients who were diagnosed with OSAHS by polysomnography(PSG)monitoring and admitted to the Department of Respiratory and Critical Care Medicine of Xuanwu Hospital of Capital Medical University from June to December 2019 were selected.According to the Montreal Cognitive Assessment(MoCA)Scale score,the patients were divided into cognitive normal group(80 patients,MoCA Scale score≥26)and cognitive impairment group(36 patients,MoCA Scale score<26).In the same period,32 normal adults with snoring as the chief complaint and excluded OSAHS by PSG monitoring who were admitted to the Department of Respiratory and Critical Care Medicine of Xuanwu Hospital of Capital Medical University were selected as the control group.General data,PSG monitoring indicators,MoCA Scale score and urine AD7c-NTP levels of the subjects were collected.Spearman rank correlation analysis was used to analyze the correlation between urine AD7c-NTP levels and MoCA Scale scores in OSAHS patients.Multivariate Logistic regression analysis was used to investigate the influencing factors of cognitive impairment in patients with OSAHS.ROC curve was used to analyze the diagnostic value of urine AD7c-NTP levels for cognitive impairment in patients with OSAHS.Results BMI,apnea hypopnea index(AHI),percentage of sleep time spend when oxygen saturation lower than 90%(SLT90%)and oxygen desaturation index(ODI)in cognitive normal group were higher than those in control group,longest apnea time(LAT)was longer than that in control group,while lowest arterial oxygen saturation(LSaO_(2))and percentage of rapid eye movement stage in total sleep time(REM%)were lower than those in control group(P<0.05).Age,BMI,AHI,SLT90%,ODI and urine AD7c-NTP level in cognitive impairment group were higher than those in control grou
作者
郭芋妙
康美美
樊晓军
张连国
王蓉
聂秀红
GUO Yumiao;KANG Meimei;FAN Xiaojun;ZHANG Lianguo;WANG Rong;NIE Xiuhong(Department of Respiratory and Critical Care Medicine,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Central Laboratory,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)
出处
《实用心脑肺血管病杂志》
2022年第5期61-67,共7页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
