神经调节蛋白4联合γ-氨基丁酸对重度阻塞性睡眠呼吸暂停低通气综合征患者认知功能障碍的预测价值  

Value of neuregulin 4 combined withγ-aminobutyric acid in predicting cognitive dysfunction among patients with severe obstructive sleep apnea-hypopnea syndrome

作　　者：王晖 肖海燕 陈平 张昊 巩远方 张金洪 张书研 温永飞 WANG Hui;XIAO Haiyan;CHEN Ping;ZHANG Hao;GONG Yuanfang;ZHANG Jinhong;ZHANG Shuyan;WEN Yongfei(Cangzhou People′s Hospital of Hebei Province,Cangzhou,Hebei,061000)

机构地区：[1]河北省沧州市人民医院,河北沧州061000

出　　处：《实用临床医药杂志》2025年第3期51-56,共6页Journal of Clinical Medicine in Practice

基　　金：河北省沧州市科技计划自筹经费项目(222106111)。

摘　　要：目的探讨神经调节蛋白4(Nrg4)联合γ-氨基丁酸(GABA)对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者认知功能障碍的预测价值。方法选取169例重度OSAHS患者作为研究对象,根据认知功能评估结果将其分为认知功能正常组89例和认知功能障碍组80例。收集患者的一般资料,采用酶联免疫吸附试验(ELISA)法检测Nrg4、GABA水平,采用受试者工作特征(ROC)曲线分析Nrg4、GABA对OSAHS患者认知功能障碍的预测价值。结果认知功能障碍组有高血压史者占比、有糖尿病史者占比和舒张压、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平均高于认知功能正常组,差异有统计学意义(P<0.05)。认知功能障碍组Nrg4、GABA水平低于认知功能正常组,差异有统计学意义(P<0.05)。认知功能障碍组的蒙特利尔认知评估量表(MoCA)评分为(12.36±2.35)分,低于认知功能正常组的(28.25±1.02)分,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高血压史、糖尿病史、舒张压、TC、TG、HDL-C、LDL-C为重度OSAHS患者认知功能障碍的危险因素(P<0.05),Nrg4、GABA、MoCA评分为重度OSAHS患者认知功能障碍的保护因素(P<0.05)。ROC曲线分析结果显示,与Nrg4、GABA单独检测相比,两者联合检测对重度OSAHS患者认知功能障碍具有更高的预测价值(P<0.05)。结论高血压史、糖尿病史、舒张压、TC、TG、HDL-C、LDL-C、Nrg4、GABA和MoCA评分均为重度OSAHS患者认知功能障碍的影响因素,联合检测Nrg4和GABA可有效预测重度OSAHS患者的认知功能障碍。Objective To investigate the predictive value of neuregulin 4(Nrg4)combined withγ-aminobutyric acid(GABA)in cognitive dysfunction among patients with severe obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 169 patients with severe OSAHS were selected as study subjects and divided into normal cognitive function group(n=89)and cognitive dysfunction group(n=80)based on cognitive function assessment results.General information of the patients was collected,and the levels of Nrg4 and GABA were detected by enzyme-linked immunosorbent assay(ELISA).Receiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of Nrg4 and GABA for cognitive dysfunction in OSAHS patients.Results The proportions of patients with a history of hypertension and diabetes,as well as the levels of diastolic blood pressure,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were significantly higher in the cognitive dysfunction group than those in the normal cognitive function group(P<0.05).The levels of Nrg4 and GABA were significantly lower in the cognitive dysfunction group than in the normal cognitive function group(P<0.05).The Montreal Cognitive Assessment(MoCA)score in the cognitive dysfunction group was significantly lower than that in the normal cognitive function group[(12.36±2.35)versus(28.25±1.02),P<0.05].Multivariate Logistic regression analysis revealed that a history of hypertension and diabetes,diastolic blood pressure,TC,TG,HDL-C,and LDL-C were risk factors for cognitive dysfunction in patients with severe OSAHS(P<0.05),while Nrg4,GABA,and MoCA scores were protective factors(P<0.05).ROC curve analysis showed that combined detection of Nrg4 and GABA had a higher predictive value for cognitive dysfunction in patients with severe OSAHS compared with either marker alone(P<0.05).Conclusion A history of hypertension and diabetes,diastolic blood pressure,TC,TG,HDL-C,LDL-C,Nrg4,GABA,and MoCA scores are all fac

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 认知功能障碍 神经调节蛋白4 Γ-氨基丁酸 

分 类 号：R749.2[医药卫生—神经病学与精神病学] R446[医药卫生—临床医学] R56