持续气道正压通气对阻塞性睡眠呼吸暂停病人认知及血清神经丝轻链蛋白、Tau蛋白的影响  

Effects of continuous positive airway pressure on cognition and serum NfL and Tau protein in patients with obstructive sleep apnea

作　　者：王迪 刘平闯 季磊 嵇桂娟 赵玲 陈碧 张文辉 WANG Di;LIU Pingchuang;JI Lei;JI Guijuan;ZHAO Ling;CHEN Bi;ZHANG Wenhui(Graduate School of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221004,China)

机构地区：[1]徐州医科大学研究生院,江苏徐州221000 [2]徐州医科大学附属医院呼吸与危重症医学科,江苏徐州221004

出　　处：《安徽医药》2025年第5期945-949,共5页Anhui Medical and Pharmaceutical Journal

基　　金：江苏省六大人才高峰项目(WSN-081);江苏省研究生科研与实践创新计划项目(SJCX23_1386)。

摘　　要：目的分析阻塞性睡眠呼吸暂停(OSA)病人认知情况,研究持续气道正压通气(CPAP)对OSA病人认知及血清神经丝轻链蛋白(NfL)、Tau蛋白的影响。方法选取2022年3月至2023年5月徐州医科大学附属医院呼吸睡眠监测中心收治的90例OSA病人,根据呼吸暂停低通气指数(AHI)分为轻度组(5~15次/小时)26例、中度组(>15~30次/小时)31例、重度组(>30次/小时)33例,另外选取同期徐州医科大学附属医院健康体检者30例作为对照组。采用蒙特利尔认知评估量表(MoCA)、简易智能状态评价量表(MMSE)评估认知功能,酶联免疫吸附分析(ELISA)检测血清NfL、Tau蛋白水平,中重度病人给予3个月CPAP治疗,比较治疗前后OSA病人认知及血清NfL、Tau蛋白的变化。结果与对照组相比,OSA组轻、中、重度组MoCA[(24.65±3.13)分、(23.69±4.34)分、(21.94±3.26)分比(27.20±1.29)分]、MMSE评分[(25.23±3.43)分、(24.53±2.14)分、(23.90±2.02)分比(26.95±2.01)分]均有下降,血清NfL[(44.48±6.07)ng/L、(71.40±14.59)ng/L、(131.82±45.24)ng/L比(30.05±10.93)ng/L]、Tau蛋白[(46.76±8.06)ng/L、(68.39±15.94)ng/L、(175.35±52.69)ng/L比(29.65±6.65)ng/L]明显升高(P<0.05)。中重度病人行CPAP治疗3月后,MoCA、MMSE评分较前提高,血清NfL、Tau蛋白较前下降(P<0.05)。结论OSA病人常合并认知损害,OSA病情越重,认知损害越重,血清NfL、Tau蛋白水平越高。CPAP治疗可以改善OSA病人认知功能,降低血清NfL、Tau蛋白水平。Objective To analyze the cognition of patients with obstructive sleep apnea(OSA)and to study the effect of continuous positive airway pressure(CPAP)on cognition and serum neurofilament light chain(NfL)and Tau protein in patients with OSA.Meth⁃ods Ninety OSA patients admitted to the respiratory sleep monitoring center of the Affiliated Hospital of Xuzhou Medical University from March 2022 to May 2023 were selected,and were assigned into 26 cases in the mild group(5-15 times/h),31 cases in the moderate group(>15-30 times/h),and 33 cases in the severe group(>30 times/h)according to the apnea hypopnea index(AHI),and 30 cases in the healthy medical checkups of the same period of time at the Affiliated Hospital of Xuzhou Medical University were selected as the control group.The MoCA and MMSE were used to assess cognitive function,and ELISA was used to detect serum NfL and Tau protein levels.Moderate and severe patients were given CPAP treatment for 3 months,and the changes in the cognition of the patients with OSA and the changes in the serum NfL and Tau protein before and after the treatment were compared.Results Compared with the control group,MoCA[(24.65±3.13)points,(23.69±4.34)points,(21.94±3.26)points vs.(27.20±1.29)points]and MMSE scores[(25.23±3.43)points,(24.53±2.14)points,(23.90±2.02)points vs.(26.95±2.01)points]decreased and serum NfL[(44.48±6.07)ng/L,(71.40±14.59)ng/L,(131.82±45.24)ng/Lvs.(30.05±10.93)ng/L]and Tau protein[(46.76±8.06)ng/L,(68.39±15.94)ng/L,(175.35±52.69)ng/L vs.(29.65±6.65)ng/L]significantly increased in the OSA group(P<0.05).After 3 months of CPAP treatment in moderate-to-severe patients,MoCA and MMSE scores were improved and serum NfL and Tau protein were decreased compared with before(P<0.05).Conclu⁃sions OSA patients are often combined with cognitive impairment,and the more severe the OSA condition,the more cognitive impairment,and the higher the serum NfL and Tau protein levels.CPAP treatment can improve the cognitive function of OSA patients and reduce the serum NfL

关 键 词：睡眠呼吸暂停 阻塞性 连续气道正压通气 认知 神经丝轻链蛋白 TAU蛋白 

分 类 号：R563.8[医药卫生—呼吸系统]