睡眠呼吸暂停综合征患者脑白质病变与认知功能的相关性  

Correlation of white matter lesions with cognitive function impairment in patients with obstructive sleep apnea syndrome

作　　者：吕祥兄[1] 张建军[1] 毛洪刚[1] 瞿杭炯 赵建江[1] 方凯[1] 

机构地区：[1]浙江萧山医院神经内科,杭州311201

出　　处：《浙江医学》2012年第11期860-862,869,共4页Zhejiang Medical Journal

基　　金：杭州市医药卫生科技计划项目（2010B067）

摘　　要：目的 探讨睡眠呼吸暂停综合征（obstructive sleep apnea syndrome,OSAS）患者脑白质病变与认知功能损害特点及不同部位白质病变与认知功能障碍的关系.方法 选取70例OSAS患者（轻度组26例,中重度组44例）及体检健康者30例（对照组）,采用年龄相关白质改变评分量表（WMLs）进行脑白质病变测定,采用蒙特利尔评估量表北京版（MoCA）进行认知功能评定;分析3组之间脑白质病变和认知功能情况,同时对其结果 进行相关性分析.结果 中重度组左右基底节区白质病变、总体脑白质病变及认知功能异常、视空间与执行、记忆、注意力异常的发生频率均明显高于对照组及轻度组（均P＜0.05）;记忆功能与基底节区及WML总分呈负相关（P＜0.05）;MoCA总分与WML总分呈负相关（P＜0.05）;而注意、视空间与执行功能与白质病变无明显相关性（P＞0.05）.结论 OSAS患者存在特定的脑白质病变与认知功能损害,其中以视空间与执行、记忆和注意能力损害突出,而记忆功能损害与基底节区病变程度相关.Objective To investigate the relationship of cognitive function impairment and white matter lesions （WML） in the patients with obstructive sleep apnea syndrome （OSAS）. Methods Seventy patients with OSAS, including 26 mild cases, 44 moderate to severe cases were enrolled in the study and 30 healthy subjects served as controls. The age-related white matter lesions scale （WMLs） and the Montreal assessment scale of Beijing version （MoCA） were used to assess the WML and the cogni- tive function; the WML and cognitive function were analyzed and compared among three groups. Results Compared to control and mild OSAS groups, moderate to serve OSAS group demonstrated higher abnormal frequency in the basal ganglia WML, the overall WML and the cognitive function, visuoconstructional and executive function, memory and attention. The memory function was negatively correlated with the basal ganglia WMLs and the overall WMLs （P〈0.05）; the whole MoCA score was negatively correlated with the overall WMLs（P〈0.05）. There were no significant correlation of WML with the attention, visuoconstructional and executive function （P 〉0.05）. Conclusion OSAS patients demonstrate selective injury in cognitive function and WML, especially in the memory, attention, visuoconstructional and executive function; while the degree of memory impairment is associated with the basal ganglia WML.

关 键 词：睡眠呼吸暂停综合征 脑白质病变 认知功能 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]