發(fā)布時間：2018-01-16 15:07

  本文關鍵詞：成人OSAHS患者認知功能障礙影響因素及海馬區(qū)磁共振波譜成像臨床價值研究　出處：《中風與神經(jīng)疾病雜志》2017年10期 　論文類型：期刊論文

  更多相關文章： 阻塞性睡眠呼吸暫停低通氣綜合征 認知功能障礙 海馬 磁共振波譜成像

【摘要】：目的研究成人阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者認知功能障礙及影響因素,分析海馬區(qū)磁共振波譜成像對OSAHS患者認知功能障礙的臨床價值。方法納入71例成年人,根據(jù)多導睡眠監(jiān)測結果分為OSAHS組和非OSAHS組,比較兩組基線資料、多導睡眠監(jiān)測值、蒙特利爾認知評估(montreal cognitive assessment,MoCA)值、海馬區(qū)磁共振波譜(magnetic resonance spectroscopy,MRS)值;對OSAHS組進行二元Logistic回歸分析及MoCA總分與海馬區(qū)MRS線性回歸分析。結果 OSAHS組血紅蛋白比非OSAHS組高(P0.05);OSAHS組在視空間與執(zhí)行、延遲記憶、注意力、MoCA總分均低于非OSAHS組(P0.05);OSAHS組在呼吸暫停低通氣指數(shù)(apnea-hypopnea index,AHI)、最長暫停時間、平均暫停時間均高于非OSAHS組,而最低血氧飽和度(SaO_2)、平均血氧飽和度(SaO_2)均低于非OSAHS組(P0.05);最低SaO_2可能是認知功能障礙的獨立保護因素(P0.05);OSAHS組海馬區(qū)MRS中N-乙酰天門冬氨酸/肌酸(NAA/Cr)、膽堿/肌酸(Cho/Cr)、N-乙酰天門冬氨酸/膽堿(NAA/Cho)均下降(P0.05);MoCA總分和NAA/Cr呈正相關(調整R2=0.63,P0.05)。結論 OSAHS認知功能障礙主要在視空間與執(zhí)行、延遲記憶、注意力等方面;最低SaO_2可能是認知功能障礙的獨立保護因素;OSAHS組NAA/Cr降低、Cho/Cr、NAA/Cho降低且NAA/Cr值隨著MoCA總分降低而降低,說明MRS對客觀評估OSAHS患者認知障礙及海馬代謝變化方面具有重要的臨床價值。
[Abstract]:Objective to study adult obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea-hypopnea syndrome, OSAHS) and the influence factors of cognitive dysfunction patients, clinical value analysis of hippocampal magnetic resonance spectroscopy on cognitive dysfunction in OSAHS patients. Methods into 71 cases of adults, according to the results of polysomnography were divided into OSAHS group and non OSAHS group comparison of two groups, the baseline data, polysomnography, Montreal cognitive assessment (Montreal cognitive, assessment, MoCA), hippocampal magnetic resonance spectroscopy (magnetic resonance spectroscopy, MRS); group OSAHS was two yuan Logistic regression and the total score of MoCA and MRS in hippocampus of linear regression analysis. Results in the OSAHS group than that of hemoglobin OSAHS group (P0.05); OSAHS group in the visual space and execution, delayed memory, attention, scores of MoCA were lower than group OSAHS (P0.05); OSAHS group in breathing Apnea hypopnea index (apnea-hypopnea, index, AHI), the longest pause time and average pause time were higher than non OSAHS group, and the lowest oxygen saturation (SaO_2), the average oxygen saturation (SaO_2) were lower than those in non OSAHS group (P0.05); SaO_2 is the lowest possible independent protective factors of cognitive function disorder (P0.05); OSAHS in MRS N- group in hippocampus of N-acetylaspartate / creatine (NAA/Cr), choline / creatine (Cho/Cr), N- N-acetylaspartate / choline (NAA/Cho) decreased (P0.05); the total score of MoCA and NAA/Cr were positively correlated (R2=0.63, P0.05). Conclusion OSAHS cognitive dysfunction mainly in the visual space and execution delay memory, attention and so on; the lowest SaO_2 may be the independent protective factors of cognitive impairment in OSAHS group; NAA/Cr Cho/Cr, NAA/Cho decreased, decreased and NAA/Cr value decreased with the total score of MoCA decreased, indicating that MRS of objective assessment of OSAHS patients with cognitive impairment and hippocampal generation The change of thanks has important clinical value.

【作者單位】： 甘肅中醫(yī)藥大學臨床醫(yī)學院;達州市中西醫(yī)結合醫(yī)院神經(jīng)內(nèi)科;甘肅省人民醫(yī)院中法神經(jīng)康復科;甘肅省人民醫(yī)院睡眠醫(yī)學中心;甘肅省人民醫(yī)院放射科;
【基金】：國家自然科學基金(No.81560228)
【分類號】：R749.1;R766
【正文快照】： 作者單位:(1.甘肅中醫(yī)藥大學臨床醫(yī)學院,甘肅蘭州730000;2.甘肅省人民醫(yī)院中法神經(jīng)康復科,甘肅蘭州730000;3.甘肅省人民醫(yī)院睡眠醫(yī)學中心,甘肅蘭州730000;4.甘肅省人民醫(yī)院放射科,甘肅蘭州730000;5.達州市中西醫(yī)結合醫(yī)院神經(jīng)內(nèi)科,四川達州635000)阻塞性睡眠呼吸暫停低通氣綜合

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