阻塞性睡眠呼吸暂停低通气综合征对患者认知功能的影响及其机制

盛寅，卢旭东，陆益民，蔡思洁，赵年*

（江苏大学附属昆山市第一人民医院呼吸内科，江苏 昆山，215300）

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摘要：

目的 探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对患者认识功能障碍的影响及其机制。方法 将我院119 例OSAHS 患者分为轻度组28 例，中度组21 例，重度组70 例；同时，选取同时期55 例单纯鼾症患者为对照组。比较四组患者的MoCA 及MMSE 评分，并分析OSAHS 各组患者中睡眠结构参数及低氧参数对认知功能的影响。结果 重度组患者的MoCA 与MMSE 总评分明显低于对照组、轻度组及中度组（P<0.05）。四组患者睡眠结构参数及低氧参数各指标水平比较，差异显著（P<0.05）。Ⅱ%和SaO2 与MoCA 评分呈正相关（P<0.05），（Ⅰ+Ⅱ）%和AHI 与MoCA 评分呈负相关（P<0.05）；AHI 与MMSE 评分呈负相 关（P<0.05）；SaO2 与MMSE评分呈正相关（P<0.05）。结论OSAHS 对患者的认知功能有一定损害，MoCA 可以作为筛查OSAHS 患者认知障碍的方法。低氧、睡眠结构紊乱等是造成OSAHS 患者认知功能减退的可能机制。

关键词：睡眠呼吸暂停低通气综合征（OSAHS）；认知障碍；睡眠多导图监测（PSG）；蒙特利尔认知评估量表（MoCA）；简易精 神状态检查量表（MMSE）

中图分类号：R766文献标志码：A文章编号：2096-1413(2018)02-0001-04

Effect of obstructive sleep apnea hypopnea syndrome on cognitive function and its mechanism
SHENG Yin, LU Xu-dong, LU Yi-min, CAI Si-jie, ZHAO Nian *
(Respiratory Medicine Department, the First People``s Hospital of Kunshan, the Affiliated Hospital of Jiangsu university, Kunshan 215300, China)

ABSTRACT: Objective To explore the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on cognitive function and its mechanism. Methods A total of 119 OSAHS patients were divided into mild group (n=28), moderate group (n=21) and severe group (n=70), and 55 cases of snoring patients were enrolled as the control group. The MoCA and MMSE scores and effect of OSAHS on cognitive function were analyzed among the four groups. Results The total MoCA and MMSE scores of the severe group were lower than those in the mild group, moderate group and control group (P<0.05). There were significant differences among the four groups in levels of sleep structure parameters and hypoxic parameters (P<0.05). There was a positive correlation between Ⅱ%, SaO2 and MoCA scores (P<0.05); (Ⅰ+Ⅱ)% and AHI were negatively correlated with MoCA scores (P<0.05). AHI was negatively correlated, and SaO2 was positively correlated with MMSE scores (P<0.05). Conclusion OSAHS is harmful to the cognitive function of the patients, and the MoCA can be used as a method for screening cognitive disorders. Hypoxia and sleep disorder are the possible mechanisms of cognitive impairment in patients with OSAHS.
KEYWORDS: obstructive sleep apnea hypopnea syndrome (OSAHS); cognitive disorders; polysomnography (PSG); montreal cognitive assessment (MoCA); mini-mental state examination (MMSE)

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