高血压合并阻塞性睡眠呼吸暂停综合征患者轻度认知功能障碍的临床特点分析  

Clinical characteristics of mild cognitive impairment in patients with hypertension and obstructive sleep apnea syndrome

作　　者：席婷 姚晓光[1] 汪迎春[1] 姚灵 李南方[1] XI Ting;YAO Xiaoguang;WANG Yingchun;YAO Ling;LI Nanfang(Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Hypertension Institute,National Health Committee Key Laboratory of Hypertension Clinical Research,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院高血压中心,新疆高血压研究所,国家卫生健康委高血压诊疗研究重点实验室,新疆乌鲁木齐830001

出　　处：《中华全科医学》2023年第8期1291-1294,1325,共5页Chinese Journal of General Practice

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202201);新疆维吾尔自治区人民医院院内项目(20200102)。

摘　　要：目的探讨高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)患者轻度认知功能障碍(MCI)的临床特点及相关风险因素。方法连续选取2021年4-10月在新疆维吾尔自治区人民医院高血压专科住院患者120例,所有患者均完善整夜多导睡眠监测、24小时动态血压及蒙特利尔认知评估量表(MoCA),MoCA评分<26定义为MCI。比较认知正常组(39例)与MCI组(81例)睡眠参数、动态血压水平等特点,并探讨MCI相关风险因素。结果总体人群中MCI检出率为67.5%(81/120);与认知功能正常组相比,MCI组夜间最低氧饱和度[81.0(77.0,85.0)%vs.86.0(79.0,88.0)%]下降,呼吸暂停低通气指数[20.1(15.3,31.6)次/h vs.6.7(2.6,26.1)次/h]、血氧饱和度<90%的时间[27.2(5.3,80.4)min vs.6.9(0.4,79.1)min]升高,在视空间/执行功能[3(2,3)分vs.4(3,5)分]、注意力[5(5,6)分vs.6(6,6)分]、延迟回忆[2(1,3)分vs.3(3,4)分]、抽象思维[1(0,1)分vs.2(1,2)分]认知领域明显减低(均P<0.05)。多元logistic回归显示,夜间最低氧饱和度是影响该人群发生MCI的独立危险因素。结论高血压合并OSAS患者MCI检出率高,夜间最低氧饱和度低是该人群MCI患病率高的危险因素。Objective To investigate the clinical features and associated risk factors of mild cognitive impairment(MCI)in patients with hypertension and obstructive sleep apnea syndrome(OSAS).Methods A total of 120 patients with hypertension who were hospitalized in the People's Hospital of Xinjiang Uygur Autonomous Region from April to October 2021 and completed overnight polysomnographic monitoring or diagnosis of OSAS were consecutively selected.All patients were evaluated by 24-hour ambulatory blood pressure and Montreal cognitive assessment scale(MoCA),and MoCA score<26 was defined as MCI.The characteristics of sleep parameters and ambulatory blood pressure were compared between the cognitively normal group(39 cases)and the MCI group(81 cases),and associated risk factors were discussed.Results The detection rate of MCI in the general population was 67.5%(81/120);Compared with the normal cognitive function group,the nighttime minimum oxygen saturation[81.0(77.0,85.0)%vs.86.0(79.0,88.0)%]decreased in the MCI group,while AHI[20.1(15.3,31.6)times/h vs.6.7(2.6,26.1)times/h],T90[27.2(5.3,80.4)min vs.6.9(0.4,79.1)min],in visual space/execution function[3(2,3)points vs.(4(3,5)points],attention[5(5,6)points vs.6(6,6)points],delay recall[2(1,3)points vs.3(3,4)points],abstract thinking[1(0,1)points vs.2(1,2)points],cognitive domains were significantly reduced(all P<0.05).Multivariate logistic regression showed that the lowest oxygen saturation at night was independent risk factor for MCI in this population.Conclusion The high prevalence of MCI in hypertensive patients with OSAS,short education and low nocturnal minimum oxygen saturation are the risk factors for the high prevalence of MCI in this population.

关 键 词：高血压 阻塞性睡眠呼吸暂停综合征 轻度认知障碍 

分 类 号：R544.1[医药卫生—心血管疾病] R563[医药卫生—内科学]