急性脑梗死合并OSAHS患者血清CypA、IMA、Gal-3与氧化应激和认知功能障碍的关系分析  

Relationship between serum CypA,IMA,Gal-3 and oxidative stress and cognitive impairment in patients with acute cerebral infarction complicated with OSAHS

作　　者：孙美玉 赵文义 王红 曹娟 王晖 张金洪 SUN Meiyu;ZHAO Wenyi;WANG Hong;CAO Juan;WANG Hui;ZHANG Jinhong(Second Department of Neurology,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China;Department of Respiratory and Critical Care,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市人民医院神经内科二区,河北沧州061000 [2]沧州市人民医院呼吸与危重症科,河北沧州061000

出　　处：《国际检验医学杂志》2025年第7期834-839,共6页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题(20220311)。

摘　　要：目的探究急性脑梗死(ACI)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清亲环素A(CypA)、缺血修饰白蛋白(IMA)、半乳糖凝集素-3(Gal-3)水平与氧化应激和认知功能障碍(CI)的关系。方法选择2020年12月至2023年10月该院收治的168例ACI合并OSAHS患者,比较不同病情严重程度患者(轻度组、中度组、重度组)的血清CypA、IMA、Gal-3及氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]水平,采用Pearson法分析血清CypA、IMA、Gal-3水平与氧化应激指标之间的相关性。统计ACI合并OSAHS患者CI的发生情况,比较认知正常组与CI组血清CypA、IMA、Gal-3水平,多因素Logistic回归模型分析ACI合并OSAHS患者发生CI的危险因素。结果轻度组、中度组、重度组血清CypA、IMA、Gal-3和MDA水平依次升高(P<0.05),血清SOD水平依次降低(P<0.05)。ACI合并OSAHS患者血清CypA、IMA、Gal-3与SOD呈负相关(P<0.05),与MDA呈正相关(P<0.05)。168例ACI合并OSAHS患者中,有79例(47.02%)发生了CI,纳入CI组。相较于认知正常组,CI组血清CypA、IMA、Gal-3水平升高(P<0.05)。多因素Logistic回归模型分析结果显示,呼吸暂停低通气指数(AHI)≥20次/小时、额颞部梗死、CypA水平升高、IMA水平升高、Gal-3水平升高是ACI合并OSAHS患者发生CI的危险因素(P<0.05)。结论ACI合并OSAHS患者血清CypA、IMA、Gal-3高表达与氧化应激和CI相关,其水平升高预示患者CI发生风险增加,早期检测三者水平对于评估ACI合并OSAHS患者病情具有较好的临床价值。Objective To investigate the relationship between serum cyclophilin A(CypA),ischemia modified albumin(IMA),galectin-3(Gal-3)levels and oxidative stress and cognitive impairment(CI)in patients with acute cerebral infarction(ACI)complicated with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 168 patients with ACI complicated with OSAHS who were admitted to the hospital from December 2020 to October 2023 were selected,and the levels of serum CypA,IMA,Gal-3 and oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]in patients with different severity(mild group,moderate group,severe group)were compared.The correlation between serum CypA,IMA,Gal-3 levels and oxidative stress indexes were analyzed by Pearson method.The incidence of CI in patients with ACI complicated with OSAHS were statistically analyzed,the levels of serum CypA,IMA and Gal-3 were compared between normal cognitive group and CI group,and the risk factors of CI in patients with ACI complicated with OSAHS were analyzed by multivariate Logistic regression model.Results The levels of serum CypA,IMA,Gal-3 and MDA in mild group,moderate group and severe group increased in turn(P<0.05),and serum SOD level decreased in turn(P<0.05).Serum CypA,IMA and Gal-3 in ACI patients complicated with OSAHS were negatively correlated with SOD(P<0.05),and positively correlated with MDA(P<0.05).Of 168 ACI patients complicated with OSAHS,79 cases(47.02%)had CI and were included in the CI group.Compared with normal cognitive group,the serum levels of CypA,IMA and Gal-3 in CI group were significantly increased(P<0.05).Multivariate Logistic regression model analysis showed that apnea hypopnea index(AHI)≥20 times/h,frontal and temporal lobe infarction,elevated CypA level,elevated IMA level,and elevated Gal-3 level were risk factors for CI in ACI patients complicated with OSAHS(P<0.05).Conclusion The high expression of serum CypA,IMA and Gal-3 in patients with ACI complicated with OSAHS is significantly correlated with oxidative stress and C

关 键 词：急性脑梗死 阻塞性睡眠呼吸暂停低通气综合征 亲环素A 缺血修饰白蛋白 半乳糖凝集素-3 氧化应激 认知功能障碍 

分 类 号：R446.1[医药卫生—诊断学]