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投稿时间：2023-04-06 网络发布日期：2023-10-20
投稿时间：2023-04-06 网络发布日期：2023-10-20
中文摘要: 目的 探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与腔隙性脑梗死患者睡眠状态、认知功能之间的关系。
方法 选取2020年7月至2022年10月安徽省第二人民医院收治的53例腔隙性脑梗死合并OSAHS患者为研究组，选取同期70例腔隙性脑梗死不伴OSAHS患者为对照组。所有患者均进行多导睡眠描记术监测评价睡眠状态，采用简易智力状态检查量表（MMSE）评价认知功能。分析睡眠状态指标与MMSE评分的相关性以及腔隙性脑梗死患者继发认知功能障碍的危险因素。
结果 研究组患者，呼吸暂停低通气指数（AHI）高于对照组，睡眠期最低血氧饱和度、平均血氧饱和度、睡眠效率、入睡潜伏期均低于对照组（P＜0.01）。研究组患者MMSE评分低于对 照组［（24.53±4.33）分vs（26.07±3.79）分，t=2.104，P＜0.05］。研究组患者认知功能障碍的比例高于对照组（30.19% vs 11.43%， χ2=6.759，P＜0.01）。AHI指数与MMSE评分呈负相关（r=-0.365，P＜0.01），睡眠期最低血氧饱和度、平均血氧饱和度与MMSE评分呈正相关（r=0.403，0.417，P＜0.01）。Logistic回归分析显示，年龄≥60岁、合并OSAHS及平均血氧饱和度＜95%是腔隙性脑梗死患者继发认知功能障碍的独立危险因素（P＜0.05）。
结论 OSAHS对腔隙性脑梗死患者的睡眠状态、认知功能有不良影响，OSAHS可进一步加重患者认知功能损害。
中文关键词: 阻塞性睡眠呼吸暂停低通气综合征 腔隙性脑梗死 睡眠 认知功能障碍
Abstract:ObjectiveTo explore the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and sleep status and cognitive function in patients with lacunar infarction.
Methods From July 2020 to October 2022, 53 patients with lacunar infarction complicated with OSAHS were selected as study group, and 70 patients with lacunar infarction without OSAHS were selected as control group. All patients were monitored by polysomnography to evaluate their sleep status, and cognitive function was evaluated by mini-mental state examination (MMSE). The correlations between sleep status indexes and MMSE score and the risk factors of secondary cognitive dysfunction in patients with lacunar infarction were analyzed. Results In study group, apnea hypopnea index (AHI) was higher than that in control group, while the minimum oxygen saturation during sleep period, average oxygen saturation, sleep efficiency and sleep latency were lower than those in control group (P＜0.01). MMSE score in study group was lower than that in control group （24.53±4.33 vs 26.07±3.79, t=2.104, P＜0.05). Compared with study group, the proportion of cognitive impairment in study group increased (30.19% vs 11.43%, P＜0.05). AHI was negatively correlated with MMSE score (r=-0.365, P＜0.01), while the minimum oxygen saturation during sleep period and average oxygen saturation were positively correlated with MMSE score (r=0.403, 0.417, P＜0.01). The results of logistic regression analysis showed that age ≥ 60 years old, OSAHS and the average oxygen saturation＜95% were the independent risk factors of secondary cognitive dysfunction in patients with lacunar infarction (P＜0.05).
Conclusion OSAHS has adverse effects on sleep status and cognitive function in patients with lacunar infarction, and can further exacerbate cognitive impairment in patients.
文章编号： 中图分类号：R766.3 R743.3 文献标志码：B
基金项目:安徽省高校科学研究项目（KJ2021A0350）
| Author Name | Affiliation |
| ZHANG Lu*, LI Xia, ZHANG Wei, WU Yanan, LYU Yujing, WANG Yu | *Department of Neurology, Anhui No.2 Provincial Peoples Hospital, Hefei, Anhui 230041, China |
引用文本：
张璐,李霞,张卫,等.阻塞性睡眠呼吸暂停低通气综合征对腔隙性脑梗死患者睡眠状态、认知功能的影响[J].中国临床研究,2023,36(10):1529-1533,1539.
张璐,李霞,张卫,等.阻塞性睡眠呼吸暂停低通气综合征对腔隙性脑梗死患者睡眠状态、认知功能的影响[J].中国临床研究,2023,36(10):1529-1533,1539.