摘要
目的探索中青年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者认知及执行功能的损害特征及机制。方法选取2018-09~2019-06就诊于山西医科大学第一医院行多导睡眠监测(PSG)诊断为OSAHS的患者50例,选取同期正常体检者(同年龄、同性别、同文化程度)50例为对照组。记录两组一般情况及低通气指数(AHI)、最低血氧饱和度(LSaO 2),对两组研究对象均行MoCA量表、数字广度测验(DST)、Stroop测验、连线测验(TMT)、韦氏成人智力量表相似性亚项、言语流畅性测验,比较两组AHI、LSaO 2、各评分量表得分之间的差异,探讨执行功能损害特点及相关机制。结果OSAHS组MoCA评分低于对照组,视空间及执行功能、注意力、语言功能较对照组差(P<0.05),两组间在命名、抽象思维、延迟回忆、定向力方面差异无统计学意义(P>0.05)。OSAHS组DST倒背得分低于对照组,TMT-B、StroopC、耗时干扰量(SIE)高于对照组(P<0.05),两组间DST顺背、TMT-A、相似性、VFT、StroopA、StroopB差异无统计学意义(P>0.05)。MoCA评分、DST倒背得分与AHI呈负相关(r=-0.459,P=0.001;r=-0.370,P=0.008),与LSaO 2呈正相关(r=0.406,P=0.003;r=0.488,P<0.001);TMT-B、StroopC耗时与AHI呈正相关(r=0.301,P=0.034;r=0.397,P=0.004),与LSaO 2呈负相关(r=-0.312,P=0.028;r=-0.329,P=0.020)。结论中青年OSAHS患者存在认知功能受损,执行受损表现在优势抑制、定势转移、工作记忆方面,AHI、LSaO 2与其相关,提示呼吸暂停和慢性缺氧是执行功能损害的可能机制。
Objective To investigate the damage characteristics of cognitive and executive function in young and middle-aged patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and its mechanism.Methods Fifty patients with OSAHS diagnosed by polysomnography(PSG) were selected in the First Hospital of Shanxi Medical University from September 2018 to June 2019,and 50 normal controls with matched age,sex and education level were chosen as control group at the same time.The general condition and apnea-hypopnea index(AHI),lowest oxygen saturation(LSaO2) were recorded in two groups,and the MoCA scale,the digital span test(DST),the Stroop test,the trail making test(TMT),and the Wechs adult intelligence scale similarity sub-item and verbal fluency test were performed.The AHI,LSaO2 and each score were compared between the two groups to explore the characteristics of executive function impairment and mechanism.Results The MoCA score in OSAHS group was lower than that in control group,and the visual space,the executive function,the attention and language function were worse than those in control group(P < 0.05).There was no difference between the two groups in name,abstract thinking,delayed recall,and orientation forces(P > 0.05).The DST backward score in OSAHS group was lower than that in control group(P < 0.05),and TMT-B,Stroop C,and time-consuming interference(SIE)were higher than that in control group(P < 0.05),there was no difference in DST,TMT-A,similarity,VFT,Stroop A and Stroop B between the two groups(P > 0.05).MoCA score and DST-backward score were negatively correlated with AHI(r =-0.459,P = 0.001;r =-0.370,P = 0.008),but positively correlated with LSaO2(r = 0.406,P = 0.003;r = 0.488,P < 0.001).TMT-B and Stroop C were positively correlated with AHI(r = 0.301,P = 0.034;r = 0.397,P = 0.004),but negatively correlated with LSaO2(r =-0.312,P =0.028;r =-0.329,P = 0.020).Conclusion The young and middle-aged patients with OSAHS manifest the damage of cognitive function,and the executive dysfunction is in the inhibition,metastasis,and working memory.AHI and LSaO2 are related to the damages,suggesting that the apnea and chronic hypoxia may be possible mechanisms for impaired executive function.
作者
张凯月
张媛媛
ZHANG Kaiyue;ZHANG Yuanyuan(Department of Neurology,First Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《山西医科大学学报》
CAS
2020年第7期700-705,共6页
Journal of Shanxi Medical University
关键词
阻塞型睡眠呼吸暂停
中青年
认知功能
执行功能
obstructive sleep apnea
young and middle-aged
cognitive function
executive function
作者简介
张凯月,女,1996-12生,在读硕士,E-mail:1026541171@qq.com;通讯作者:张媛媛,E-mail:zyy3018@souhu.com。
