氧化应激与重度阻塞性睡眠呼吸暂停低通气综合征患者认知障碍的关系  

Role of oxidative stress and sleep structure on cognitive dysfunction in patients with obstructive sleep apnea-hypopnea syndrome

作　　者：李龙[1] 余勤[1] 张佳宾[1] 陈明[2] 

机构地区：[1]兰州大学第一医院呼吸科,甘肃兰州730000 [2]兰州大学第一医院核医学科,甘肃兰州730000

出　　处：《临床荟萃》2013年第11期1232-1234,共3页Clinical Focus

基　　金：兰州市科技局社会事业发展支持行动计划(2009-1-53)

摘　　要：目的探讨血清丙二酸(MDA)、一氧化氮(NO)和超氧化物歧化酶(SOD)水平变化在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者认知功能障碍发生中的生物学作用。方法选择经多导睡眠图确诊的重度OSAHS患者24例及健康体检者16例进行睡眠检测,使用蒙特利尔认知评估(北京版)指导手册(MOCA)评分检测认知功能,用镉分光比色法测定清晨血清SOD和MDA及NO浓度,并比较SOD、MDA和NO与睡眠紊乱指标、认知功能分数的关系。结果 OSAHS组认知能力总分及其亚项延迟回忆、计算力、词语流畅性得分显著低于对照组(P<0.01);血清MDA浓度在OSAHS组明显增高,(4.88±0.47)mmol/L vs(3.36±0.34)mmol/L(P<0.01);血清NO水平在OSAHS组明显增高,(8.45±1.68)μmol/L vs(5.55±2.31)μmol/L(P<0.01);血清SOD浓度明显低于对照组,(89.36±4.23)mmol/L vs(133.24±4.54)mmol/L(P<0.01)。MDA、NO和SOD浓度与睡眠紊乱指标、认知能力总分及其亚项延迟回忆、计算力、词语流畅性等有显著相关性(P<0.05)。结论睡眠结构紊乱可导致氧自由基MDA、NO产生过多,抗氧化能力下降,从而引起神经系统损伤,提示睡眠障碍诱导的氧化应激可能是OSAHS患者认知功能受损的生化基础。Objective To investigate serum malonic acid（MDA）, nitric oxide（NO） and superoxide dismutase （SOD） levels in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） patients with cognitive dysfunction in the biological effects. Methods Polysomnography was administered to 24 patients with serious OSAHS and 16 education and BMI-matched controls, all the cases were measured serum SOD, NO and MDA level by spectrophotometry and were conducted by the Montreal Cognitive Assessment. Results The scores of MoCA and its subitems including calculation, language and delay recall in the patients with OSAHS were significantly lower than those of controls （ P 〈0.01）. The serum MDA and NO level of the patients were significantly higher than those of controls, （4.88 ± 0.47） mmol/L vs （3.36± 0.34） mmol/L, （8.45 ± 1.68） ±mol/L vs （5.55 ± 2.31 ） μmol/L （both P 〈 0.01）. The serum SOD level in patients was significantly lower than that of controls, （89.36 ± 4.23） mmol/L vs （133.24±4.54） mmol/L（ P 〈0.01）. The levels of MDA,NO and SOD significantly correlated with the indexes of sleep-apnea disorder and the scores of MoCA including calculation,language and delay recall（ P 〈0.05）. Conclusion Oxidative stress induced by sleep disorder may play an important role in cognitive impairment in patients with OSAHS.

关 键 词：睡眠呼吸暂停综合征 认知障碍 超氧化物歧化酶 丙二醛 一氧化氮 

分 类 号：R563.8[医药卫生—呼吸系统]