血清神经肽Y水平和转化生长因子β/Smad信号通路与慢性阻塞性肺疾病-阻塞性睡眠呼吸暂停低通气综合征重叠综合征患者认知障碍的相关性研究  

Correlations of Serum NPY Level and TGF-β/Smad Signaling Pathway to Cognitive Disorder in Patients with COPDOSAHS Overlap Syndrome

作　　者：刘萍[1] 曾强[2] 王丰[1] 孙楷[1] LIU Ping;ZENG Qiang;WANG Feng;SUN Kai(Department of Pulmonary and Critical Care Medicine,the Fourth People's Hospital of Zigong,Zigong 643000,China;Department of Respiratory Medicine,the Third People's Hospital of Mianyang,Mianyang 621000,China)

机构地区：[1]四川省自贡市第四人民医院呼吸与危重症医学科,643000 [2]四川省绵阳市第三人民医院呼吸内科,621000

出　　处：《实用心脑肺血管病杂志》2020年第2期58-63,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：自贡市重点科技计划项目(2013ZC23)。

摘　　要：背景目前,慢性阻塞性肺疾病(COPD)-阻塞性睡眠呼吸暂停低通气综合征(OSAHS)重叠综合征患者认知障碍的发生机制尚未完全明确,早期诊断及治疗难度较大,而寻找有效并客观地评价COPD-OSAHS重叠综合征患者认知障碍的指标具有重要意义。目的分析血清神经肽Y(NPY)水平和转化生长因子β(TGF-β)/Smad信号通路与COPD-OSAHS重叠综合征患者认知障碍的相关性。方法选取2016年4月—2019年6月自贡市第四人民医院呼吸内科收治的COPD-OSAHS重叠综合征患者36例作为重叠综合征(OS)组,另选取同期收治的单纯COPD患者52例作为COPD组,单纯OSAHS患者52例作为OSAHS组,体检健康者45例作为健康对照组。比较四组受试者简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分及血清NPY、TGF-β、Smad1、Smad3、Smad7水平,有无认知障碍的COPD-OSAHS重叠综合征患者血清NPY、TGF-β、Smad1、Smad3、Smad7水平;血清NPY、TGF-β、Smad1、Smad3、Smad7水平与COPD-OSAHS重叠综合征患者MMSE评分、MoCA评分的相关性分析采用Pearson相关分析。结果(1)COPD组、OSAHS组、OS组患者MMSE评分、MoCA评分低于健康对照组,OS组患者MMSE评分、MoCA评分低于COPD组和OSAHS组(P<0.05)。(2)COPD组、OSAHS组、OS组患者血清NPY、TGF-β、Smad1、Smad3、Smad7水平高于健康对照组,OS组患者血清NPY、TGF-β、Smad1、Smad3、Smad7水平高于COPD组和OSAHS组(P<0.05)。(3)有认知障碍的COPD-OSAHS重叠综合征患者血清NPY、TGF-β、Smad1、Smad3、Smad7水平高于无认知障碍的COPD-OSAHS重叠综合征患者(P<0.05)。(4)Pearson相关分析结果显示,血清NPY、TGF-β、Smad1、Smad3、Smad7水平均与COPD-OSAHS重叠综合征患者MMSE评分、MoCA评分呈负相关(P<0.05)。结论COPD-OSAHS重叠综合征患者认知障碍程度重于单纯COPD患者、单纯OSAHS患者,而COPD-OSAHS重叠综合征患者认知障碍发生和加重与血清NPY水平升高及TGF-β/Smad信号通路Background Mechanism of cognitive disorder in patients with COPD-OSAHS overlap syndrome is not yet very clear,and it is difficult to early diagnose and treat,thus it is of great significance to find the effective and objective index to evaluate cognitive disorder in patients with COPD-OSAHS overlap syndrome.Objective To analyze the correlations of serum NPY level and TGF-β/Smad signaling pathway to cognitive disorder in patients with COPD-OSAHS overlap syndrome.Methods From April 2016 to June 2019,a total of 36 patients with COPD-OSAHS overlap syndrome were selected as OS group in the Department of Respiratory Medicine,the Fourth People's Hospital of Zigong,meanwhile 52 patients with COPD alone were selected as COPD group,52 patients with OSAHS alone were selected as OSAHS group,moreover 45 healthy people were selected as control group.MMSE score,MoCA score,as well as serum levels of NPY,TGF-β,Smad1,Smad3 and Smad7 were compared in the four groups,moreover serum levels of NPY,TGF-β,Smad1,Smad3 and Smad7 were compared in COPD-OSAHS overlap syndrome patients with cognitive disorder or not;Pearson correlation analysis was used to analyze the correlations of serum levels of NPY,TGF-β,Smad1,Smad3 and Smad7 with MMSE score,MoCA score in patients with COPD-OSAHS overlap syndrome.Results(1)MMSE score and MoCA score in COPD group,OSAHS group and OS group were statistically significantly lower than those in control group,meanwhile MMSE score and MoCA score in OS group were statistically significantly lower than those in COPD group and OSAHS group(P<0.05).(2)Serum levels of NPY,TGF-β,Smad1,Smad3 and Smad7 in COPD group,OSAHS group and OS group were statistically significantly higher than those in control group,meanwhile serum levels of NPY,TGF-β,Smad1,Smad3 and Smad7 in OS group were statistically significantly higher than those in COPD group and OSAHS group(P<0.05).(3)Serum levels of NPY,TGF-β,Smad1,Smad3 and Smad7 in COPD-OSAHS overlap syndrome patients with cognitive disorder were statistically significantly highe

关 键 词：慢性阻塞性肺疾病 阻塞性睡眠呼吸暂停低通气综合征 重叠综合征 认知障碍 神经肽Y 转化生长因子Β SMAD蛋白质类 

分 类 号：R563.9[医药卫生—呼吸系统] R563.8[医药卫生—内科学]