氧化应激与成人阻塞性睡眠呼吸暂停低通气综合征患者认知障碍的相关性研究  

Oxidative Stress in Obstructive Sleep Apnea Hypopnea Syndrome Patients with Cognition Dysfunction

作　　者：黄建钗[1,2] 周金玲[1,2] 林其昌[1,2] 王碧瑛[1,2] 金咏絮[1,2] 丁海波[1,2] 

机构地区：[1]福建医科大学附属第一医院呼吸内科,福建省睡眠呼吸疾病诊治中心 [2]福建医科大学呼吸系病研究室,福州350005

出　　处：《福建医科大学学报》2014年第5期308-312,共5页Journal of Fujian Medical University

基　　金：福建省卫生厅青年科研课题(2012-2-43)

摘　　要：目的探讨氧化应激与成人阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者认知障碍的相关性。方法选取2012年2月-2013年2月睡眠呼吸疾病诊治中心确诊的成人OSAHS患者41例作为病例组,同期选取体检中心健康成年人44例作为对照组。采用简易智能状态量表(MMSE)和蒙特利尔认知量表(MoCA)中文版评估认知状况;分别采用分光光度计法、双抗体夹心酶联免疫吸附法测定血白细胞NADPH氧化酶(NOX)活性及血浆8-羟基脱氧鸟苷(8-OHdG)的浓度,并进行组间比较及相关性分析。结果 (1)根据MMSE评分标准,2组认知障碍的发生率差别无统计学意义(P=0.174),根据MoCA评分标准,OSAHS组认知障碍发生率(63.4%)较对照组(22.7%)明显升高(P=0.000);OSAHS患者认知损害主要表现为延迟回忆、注意力、语言能力、视空间与执行功能、抽象能力的损害。(2)OSAHS组较对照组NOX活性增强,血浆8-OHdG浓度升高(P均<0.01)。(3)OSAHS合并认知障碍组较无认知障碍组NOX活性增强(P<0.01),血浆8-OHdG浓度升高(P<0.05)。(4)随OSAHS病情加重,MMSE、MoCA评分逐渐降低,NOX活性逐渐增强,8-OHdG浓度逐渐升高,差别有统计学意义(P均<0.05)。(5)OSAHS患者MMSE评分与NOX活性无明显相关性,差别无统计学意义(P=0.56),而与8-OHdG浓度呈显著的负相关(P=0.001),OSAHS患者MoCA评分与NOX活性、8-OHdG浓度呈显著的负相关(PNOX=0.045,P8-OHdG=0.001)。结论 OSAHS患者认知障碍发生率增高,氧化应激可能是OSAHS相关认知功能损害的发病机制之一。Objective To assess the oxidative stress status in OSA HS patients with cognition dysfunction ,and explore the pathophysiology mechanism of the cognition impairment in these patients . Method 41 OSAHS patients and 44 healthy subjects were collected from February in 2012 to February in 2013 in this study . In all of the subjects ;cognition function was assessed by the Mini‐Mental State Examination （MMSE） and the Montreal Cognitive Assessment （MoCA）;the NADPH oxidase（NOX）activity in leucocyte was assessed by spectrophotometry ,the serum concentration of 8‐hydroxy‐deoxyguanosine （8‐OHdG） was detected by sandwich ELISA ,all of the datas were analyzed . Result （1）According to MMSE ,the prevalence of cognition impairment had no difference between OSAHS patients and normal objects （P=0 .174） ,but according to MoCA ,the prevalence of cognition impairment in OSAHS patients （63 .4% ） significantly increased when compared with normal objects （22 .7% ） （P= 0 .000）;the major cognition impairments in OSAHS patients were delay recall , attention , language , visual spatial and executive function and abstract ability . （2）The NOX activity in leucocyte and the serum concentration of 8‐OHdG in OSAHS patients were more higher than normal objects （ both P〈 0 .01） . （3）The NOX activity and 8‐OHdG in OSAHS patients with cognition impairment were more higher than those without cognition impairment（PNOX 〈 0 .01 , P8‐OHdG 〈 0 .05） . （4）With the worsening of OSAHS ,the score of MMSE and MoCA were gradually decreased ,the NOX activity and serum concentration of 8‐OHdG were gradually increased（ all P〈 0 .05） . （5）The score of MMSE had no correlation with the NOX activity （P=0 .56） ,but had significantly negative correlation with serum concentration of 8‐OHdG（P=0 .001） , the score of MoCA was significantly negative correlated with the NOX activity and serum concentration of 8‐OHdG（PNOX =0 .045 , P8‐OHdG = 0 .001） . Conclusion There was a

关 键 词：氧化性应激 睡眠呼吸暂停综合征 睡眠呼吸暂停 阻塞性 认知障碍 

分 类 号：R766[医药卫生—耳鼻咽喉科]