血清HIF-1和Ngb变化与OSAHS加重脑梗死患者决策功能障碍的关系  

Relationship of changes of serum HIF-1 and Ngb with decision-making dysfunction in patients with cerebral infarction complicated with obstructive sleep apnea hypopnea

作　　者：韩林华[1] 杨瑞 王红阳 李建民 

机构地区：[1]唐山开滦总医院林西医院,河北唐山063000 [2]华北理工大学附属医院,河北唐山063000

出　　处：《临床肺科杂志》2016年第4期674-677,共4页Journal of Clinical Pulmonary Medicine

基　　金：河北省教育厅重点资助项目(No ZH2012046)

摘　　要：目的探讨低氧诱导因子-1(HIF-1)和脑红蛋白(Ngb)变化与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)加重脑梗死患者决策功能障碍的关系。方法以164例OSAHS合并脑梗死患者为研究对象,以168例同期住院的单纯脑梗死患者为对照组。采用爱荷华赌博任务(IGT)评测两组患者的决策功能。酶联免疫吸附法(ELISA)法测定血清低氧诱导因子-1(HIF-1)和脑红蛋白(Ngb)含量。结果病例组有决策功能障碍检出比例(58.17%)显著高于对照组(33.93%),差异有统计学意义(P<0.05);与对照组比较,病例组IGT的三、四、五阶段及总分评分降低,差异有统计学意义(P<0.05);与对照组比较,病例组血清HIF-1和Ngb水平升高,差异有统计学意义(P<0.05);病例组内AHI血清HIF-1和Ngb水平呈正相关,差异有统计学意义(均P<0.01),LSaO_2与血清HIF-1和Ngb水平呈负相关,差异有统计学意义(均P<0.01);病例组内血清HIF-1和Ngb水平分别与IGT各阶段及总分评分呈负相关,差异有统计学意义(均P<0.01)。多元逐步回归显示Ngb和HIF-1水平变化是OSAHS加重脑梗死患者决策功能障碍关键因素。结论 OSAHS可加重脑梗死患者决策功能障碍,与血清HIF-1及Ngb水平变化有关。Objective To investigate the relationship between the changes of serum HIF-1 and Ngb and decision-making dysfunction in patients with cerebral infarction complicated with obstructive sleep apnea hypopnea （ OS- AHS）. Methods 164 OSAHS patients complicated with cerebral infarction were chosen as the case group and 168 cerebral infarction patients without OSAHS during the same period were collected as the control group. The decision- making dysfunction was evaluated with Iowa gambling task （IGT） , and the serum HIF-1 and Ngb were determined by enzyme-linked immunosorbent （ELISA） method. Results The decision-making dysfunction proportion was significantly higher in the case group （58.17%） than in the control group （33.93%） （ P 〈 0.05 ）. Compared with the control group, the scores of IGT at the third, fourth and fifth stages were lower in the case group （ P 〈 0. 05 ）. The levels of serum HIF-1 and Ngb were higher in the case group than in the control group （P 〈0. 05 ）, and they were re- spectively negatively correlated with AHI, while respectively negative correlated with LSaO2 in the case group （ P 〈 0. 01 ）. HIF-1 and Ngb were respectively negatively correlated with IGT scores in the case group （ P 〈 0. 01 ）. Multivariate stepwise regression analysis showed that the levels of Ngb and HIF-1 were the key factors in the decision making dysfunction of OSAHS patients complicated with cerebral infarction. Conclusion OSAHS can aggravate the decision-making dysfunction in patients with cerebral infarction, which is related with the changes of serum HIF-1 and Ngb.

关 键 词：阻塞性睡眠呼吸暂停 脑梗死 决策障碍 低氧诱导因子-1 脑红蛋白 

分 类 号：R743.3[医药卫生—神经病学与精神病学]