低氧诱导因子-1与阻塞性睡眠呼吸暂停低通气综合征合并脑梗死患者认知功能的相关性研究  

Correlation between HIF-1 and cognitive function in infarct of brain with obstructive sleep apnea hypopnea syndrome

作　　者：杨瑞[1] 赵雅宁[1] 李建民[1] 

机构地区：[1]河北联合大学护理与康复学院,河北唐山063000

出　　处：《现代预防医学》2015年第3期569-572,共4页Modern Preventive Medicine

摘　　要：目的探讨低氧诱导因子-1(HIF-1)与阻塞性睡眠呼吸暂停低通气综合症(OSAHS)合并脑梗死认知障碍的相关性。方法对79例脑梗死患者均进行多导睡眠图(PSG)、简易智能筛查(MMSE)、洛文斯顿作业疗法认知评定成套测验(LOTCA)检测,分为OSAHS合并脑梗死组49例和单纯脑梗死组30例(对照组)。同时采集两组患者静脉血,以ELISA法测定所采集血清HIF-1浓度。结果与对照组比较,合并组患者MMSE及LOTCA各项评分均降低,血清HIF-1水平升高(P<0.05);合并组内中重度认知障碍患者的LOTCA各项评分均低于轻度认知障碍组,血清HIF-1水平则显著升高,P均<0.05;相关性分析显示:合并组HIF-1水平与MMSE、LOTCA评分中知觉、视运动组织、思维运作及总分均呈负相关(r=-0.66、-0.30、-0.44、-0.35、-0.50,P均<0.05),与定向力的相关性未见有统计学意义(P>0.05);同时,合并组MMSE评分与年龄、BMI、HIF-1、AHI、有慢性病呈负相关(r=-0.48、-0.53、-0.56、-0.76、-0.60,P均<0.05),与受教育年限呈正相关(r=0.33,P<0.05);与性别及梗死部位相关性未见有统计学意义(P>0.05)。多元逐步回归分析显示:与认知功能有关的影响因素依次是AHI、HIF-1、慢性病。结论OSAHS合并脑梗死患者认知功能受损且与血清HIF-1水平升高有关。HIF-1可能参与了OSAHS加重脑梗死认知障碍的过程,但并不能特异说明其对具体哪项认知功能的受损有影响。Objective To explore the correlation between hypoxia-inducible factor-1（HIF-1） and cognitive function in infarct of brain combined with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods All the cerebral infarction patients were measured for cognitive function by mini-mental state examination（MMSE） and the Loewenstein occupational therapy cognitive assessment（LOTCA）. Seventy-nine patients of cerebral infarction combined with impaired cognitive function were selected and divided into 2 groups based on PSG. These 2 groups were OSAHS group with 49 persons and control group with 30 persons（patients with pure cerebral infarction）. Blood specimens were collected in both groups, and ELISA was used to examine the levels of HIF-1in serum. Results Compared with the control group, the cognitive test scores in the OSAHS group were significantly lower while the level of HIF-1 was higher. In the OSAHS group, the scores of each cognitive test in LOTCA in sever cognitive dysfunction group were lower than those in mild cognitive dysfunction group. The more serious the cognitive dysfunction, the higher the level of HIF-1.There is negative correlation between scores of MMSE, perception, visual movement organization and thinking test scores and the levels of HIF-1 in serum（r=-0.66,-0.30,-0.44,-0.35,-0.50, P〈0.05）. The correlation between orientation and the level of HIF-1had no statistical significance. In the OSAHS group, the scores of MMSE were negatively related to age, BMI, HIF-1, AHI and chronic disease（r=-0.48,-0.53,-0.56,-0.76,-0.60, P〈0.05） and positively related to education level（r=0.33, P〈0.05）. There was no significant correlation between the cognitive function and gender or infarct site. Multiple regression analysis shows AHI, HIF-1and chronic disease were associated with cognitive function. Conclusion Patients with OSAHS have low cognitive function scores.This may be related to the higher HIF-1 levels. HIF-1 may contribute to the effect of OSAHS on cerebral infarction cognit

关 键 词：睡眠呼吸暂停 阻塞性 脑梗死 认知障碍 低氧诱导因子-1 

分 类 号：R651[医药卫生—外科学]