NO/ET-1及HCY水平对重度OSAHS患者认知功能障碍的诊断效能  

Diagnostic efficiency of NO/ET-1 and HCY level in severe OSAHS patients with cognitive impairment

作　　者：朱晓颖 刘聪辉 戈艳蕾 王红阳 陈前程 李洪力 张海芳 张慈 张倩 李建 ZHU Xiaoying;LIU Conghui;GE Yanlei;WANG Hongyang;CHEN Qiancheng;LI Hongli;ZHANG Haifang;ZHANG Ci;ZHANG Qian;LI Jian(Department of Respiration,North China University of Science and Technology Affiliated Hospital,Tangshan,063000,China;Department of Endocrinology,North China University of Science and Technology Affiliated Hospital;Department of Ultrasonography,North China University of Science and Technology Affiliated Hospital)

机构地区：[1]华北理工大学附属医院呼吸科,河北唐山063000 [2]华北理工大学附属医院内分泌科 [3]华北理工大学附属医院超声科

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第22期1691-1695,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2017年河北省医学重点研究课题(No:20170915);2014年度河北省医学科学研究重点课题计划(No:20140500)

摘　　要：目的:探讨血清同型半胱氨酸(HCY)和一氧化氮(NO)与内皮素-1(ET-1)比值对重度OSAHS患者认知功能障碍的诊断效能,为干预治疗重度OSAHS伴有认知功能障碍的患者提供新的临床依据。方法:选取OSAHS患者86例,分为轻度组(22例)、中度组(23例)和重度组(41例),以健康体检者50例作为对照组。比较4组血清HCY及NO/ET-1水平,应用蒙特利尔认知评估量表评估重度OSAHS组轻度认知功能障碍的发生情况,分析重度OSAHS组患者血清HCY、NO/ET-1水平与认知功能的相关性。结果:重度OSAHS患者血清HCY水平[(32.28±3.92)μmol/L]均高于中度组[(26.34±4.05)μmol/L]及轻度组[(18.62±3.29)μmol/L];NO/ET-1水平(0.69±0.19)均低于中度组(2.76±0.28)及轻度组(3.98±0.37),均差异有统计学意义(P<0.05)。血清HCY水平与MoCA总分及其亚项评分均呈负相关性(P<0.05),NO/ET-1与MoCA总分及其亚项评分均呈正相关性(P<0.05),HCY与NO/ET-1呈负相关性(P<0.05)。血清HCY及NO/ET-1水平预测重度OSAHS患者认知功能障碍的ROC曲线下面积分别为0.788(95%CI 0.654～0.921)、0.770(95%CI0.642～0.899)。结论:血清HCY、NO/ET-1是重度OSAHS患者认知功能障碍形成的主要因素,HCY水平与认知损害程度呈负相关,NO/ET-1与认知损害程度呈正相关。Objective：To investigate the diagnostic efficiency of HCY and NO/ET-1 to cognitive dysfunction in patients with severe obstructive sleep apnea hypopnea syndrome,and to interfere with the cognitive function of severe OSAHS patients.Method：Eighty-six patients with OSAHS were divided into mild group（22 cases）,moderate group（23 cases）,severe group（41 cases）and healthy physical examination group（50 cases）.The levels of serum HCY and NO/ET-1 were compared between the four groups.The Montreal cognitive assessment scale was used to evaluate the incidence of mild cognitive impairment in severe OSAHS group,and the correlation between the level of serum HCY,NO/ET-1 and cognitive function in severe OSAHS group was analyzed.Result：The level of serum HCY in patients with severe OSAHS with cognitive impairment was（32.28±3.92）μmol/L,higher than that of the cognitive moderate group（26.34±4.05）μmol/L,and mild group（18.62±3.29）μmol/L.The level of serum NO/ET-1 in patients with severe OSAHS with cognitive impairment was（0.69±0.19）,higher than that of the cognitive moderate group（2.76±0.28）,and mild group（3.98±0.37）,the difference was statistically significant（P〈0.05）.In severe group,there was a negative correlation between the level of serum HCY and the score of MoCA and its subscores（P〈0.05）,and there was a positive correlation between the total scores of NO/ET-1 and MoCA and their subscores（P〈0.05）,and negative correlation between HCY and NO/ET-1（P〈0.05）.The area under the ROC curve of predicting serum HCY and NO/ET-1 levels in severe OSAHS patients with cognitive impairment were 0.788（95%CI 0.654-0.921）and 0.770（95%CI 0.642-0.899）.Conclusion：Serum HCY and NO/ET-1 were the factors influencing the formation of cognitive impairment in severe OSAHS patients.The level of HCY was negatively correlated with the degree of cognitive impairment,and NO/ET-1 was positively correlated with the degree of cognitive impairment.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 蒙特利尔认知量表 认知功能 同型半胱氨酸 内皮素-1 一氧化氮 

分 类 号：R563.8[医药卫生—呼吸系统]