持续性气道正压通气对阻塞性睡眠呼吸暂停低通气综合征患者认知功能的影响及机制研究  

Effect and Mechanism of Continuous Positive Airway Pressure on Cognitive Function in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：罗利绵 李豫琦 张妍 胡丹丹 李琪[1] LUO Li-mian;LI Yu-qi;ZHANG Yan;HU Dan-dan;LI Qi(Department of Respiratory Medicine,General practice,Puren Hospital,Wuhan University of Science and Technology,Wuhan,Hubei,430080,China)

机构地区：[1]武汉科技大学附属普仁医院呼吸内科全科,湖北武汉430080

出　　处：《现代生物医学进展》2025年第2期249-256,共8页Progress in Modern Biomedicine

基　　金：中国金属学会健康卫生科研项目(JKWS202005)。

摘　　要：目的:探讨持续性气道正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征患者(OSAHS)的认知功能及血清促红细胞生成素(EPO)、缺氧诱导因子-1α(HIF-1α)的影响。方法:选取2023年1月-2024年1月武汉科技大学附属普仁医院呼吸内科收治的80例OSAHS患者,按照随机数字表法分为对照组40例和试验组40例。对照组给予常规治疗,试验组给予CPAP联合常规治疗,连续治疗3个月,比较两组的临床疗效、治疗前后的呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度(LSaO_(2))、老年认知功能减退知情者问卷(IQCODE)、蒙特利尔认知评估量表(MoCA)及血清EPO、HIF-1α变化情况。结果:治疗前,两组的睡眠监测指标、认知评估及血清指标比较,差异均无统计学意义(P>0.05),治疗3个月后,试验组治疗总有效率高于对照组(P<0.05);两组AHI、LSaO_(2)较治疗前均改善,且试验组AHI低于对照组,LSaO_(2)高于对照组(P<0.05);两组认知功能较治疗前改善,且试验组MoCA评分高于对照组,IQCODE评分低于对照组(P<0.05);两组血清EPO、HIF-1α低于治疗前,且试验组低于对照组(P<0.05);血清EPO、HIF-1α与MoCA评分呈负相关,与IQCODE评分呈正相关。结论:CPAP联合常规治疗OSAHS患者效果显著,可有效改善患者认知功能及血清EPO、HIF-1α表达水平,且EPO、HIF-1α水平与OSAHS患者认知功能障碍严重程度有一定相关性。Objective:To investigate the effects of continuous positive airway pressure(CPAP)on cognitive function and serum erythropoietin(EPO)and hypoxia-inducing factor 1-Alpha(HIF-1α)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:A total of 80 OSAHS patients admitted to the respiratory Department of Puren Hospital Affliated to Wuhan University of Science and Technology from January 2023 to January 2024 were selected.These patients were divided into control groupp(40 cases)and test group(40 cases)according to the random number table method.The control group was given conventional treatment,while the test group was given CPAP combined with conventional treatment for 3 months.The clinical efficacy,apnea hypoventilation index(AHI),lowest oxygen saturation(LSaO_(2)),informant questionnaire on cognitive decline in the elderly(IQCODE),montreal cognitive assessment scale(MoCA)and serum EPO and HIF-1α were compared between the two groups before and after treatment.Results:Before treatment,there were no significant dfferences in sleep monitoring indexes,cognitive scale evaluation and serum indexes between the two groups(P>0.05).After 3 months of treatment,the total effective rate of experimental group was higher than that of control group(P<0.05).AHI and LSaO_(2) in both groups were improved compared with those before treatment,and AHI in test group was lower than that in control group,LSaO,was higher than that in control group(P<0.05).The cognitive function of the two groups was improved compared with that before treatment,and the MoCA score of the test group was higher than that of the control group,and the IQCODE score was lower than that of the control group(P<0.05).Serum EPO and HIF-1α in the two groupswere lower than before treatment,and the test group was lower than the control group(P<0.05).Serum EPO and HIF-1α were negatively correlated with MoCA score and positively correlated with IQCODE score.Conclusion:CPAP is effective in the treatment of OSAHS patients,and can effectively improve the c

关 键 词：持续性气道正压通气 阻塞性睡眠呼吸暂停 认知功能 促红细胞生成素 缺氧诱导因子-1Α 

分 类 号：R3[医药卫生—基础医学] R56