摘要
目的:探讨男性阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血清睾酮、雌二醇水平及其与轻度认知功能障碍(mild cognitive impairment,MCI)的关联。方法:共纳入男性OSAHS患者168例,将其分为OSAHS伴MCI组(85例)和OSAHS不伴MCI组(83例)。比较两组患者的基本情况、睡眠呼吸监测指标及血清性激素水平,采用Logistic回归评估男性OSAHS患者伴MCI的影响因素并绘制ROC曲线。采用Pearson相关性分析评估OSAHS伴MCI患者血清睾酮、雌二醇水平与血清IL-6和MMP-9水平的相关性。结果:两组患者的年龄、高血压、糖尿病、体重指数(BMI)、呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度(LSaO_(2))、氧降指数和觉醒指数均无统计学差异(P>0.05),两组吸烟史和SaO_(2)<90%时间占总监测时间的百分比(T90)比较,差异有统计学意义(P<0.05)。男性OSAHS伴MCI组患者血清睾酮、雌二醇和泌乳素水平与不伴MCI组相比均显著降低(P<0.01)。Logistic回归显示T90是男性OSAHS伴发MCI的独立危险因素(P<0.01),血清睾酮和雌二醇水平是男性OSAHS伴发MCI的独立保护因素(P<0.01)。联合睾酮和雌二醇诊断男性OSAHS伴发MCI的ROC曲线下面积为0.806,敏感度及特异度分别为83.53%和79.27%。男性OSAHS伴发MCI患者中血清睾酮水平与血清IL-6和MMP-9水平呈负相关(r分别为-0.683和-0.607,P<0.05);血清雌二醇水平与血清IL-6和MMP-9水平呈负相关(r分别为-0.662和-0.615,P<0.05)。结论:血清睾酮和雌二醇水平降低与男性OSAHS患者伴发MCI具有关联性。
Objective:To investigate serum testosterone and estradiol levels in male patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and their association with mild cognitive impairment(MCI).Methods:A total of 168 male patients with OSAHS were included and divided into OSAHS with MCI group(85 cases)and OSAHS without MCI group(83 cases).The basic information,sleep breathing monitoring indicators and sex hormone levels between the two groups were compared.The influencing factors of male OSAHS patients with MCI were evaluated by Logistic regression,and ROC curve was drawn to evaluate the corresponding diagnostic values.Pearson correlation analysis was used to evaluate the correlation between serum levels of testosterone and estradiol and serum levels of IL-6 and MMP-9.Results:There were no significant differences in age,hypertension,diabetes,body mass index(BMI),apnea hypopnea index(AHI),minimum oxygen saturation at night(LSaO_(2)),oxygen drop index and arousal index between the two groups(P>0.05).There were significant differences in smoking and the percentage of SaO_(2)<90% in the total monitoring time(T90)between the two groups(P<0.05).The serum levels of testosterone,estradiol and prolactin in male OSAHS with MCI group were significantly lower than those in male OSAHS without MCI group(P<0.01).Logistic regression analysis showed that T90 was an independent risk factor for male OSAHS with MCI(P<0.01),and serum testosterone and estradiol levels were independent protective factors for OSAHS with MCI in male patients(P<0.01).The area under ROC curve of combined testosterone and estradiol was 0.806,and the sensitivity and specificity were 83.53% and 79.27%,respectively.There was a negative correlation between serum testosterone level and serum IL-6 and MMP-9 levels(r=-0.683,-0.607,P<0.05);and serum estradiol level was negatively correlated with serum IL-6 and MMP-9 levels(r=-0.662,-0.615,P<0.05).Conclusion:Decreased serum testosterone and estradiol levels were associated with MCI in male OSAHS patients.
作者
韩庆宇
赵琳
李娟
陈晓鹏
钱炜
HAN Qingyu;ZHAO Lin;LI Juan;CHEN Xiaopeng;QIAN Wei(Department of Otolaryngology-Head and Neck Surgery,Affiliated People's Hospital of Jiangsu University,Zhenjiang Jiangsu 212002,China;Department of Neurology,Affiliated People's Hospital of Jiangsu University,Zhenjiang Jiangsu 212002,China)
出处
《江苏大学学报（医学版）》
CAS
2023年第5期432-436,共5页
Journal of Jiangsu University：Medicine Edition
基金
镇江市科技创新基金(SH2022073)
镇江市第一人民医院院级科研基金(Y2019033)。
