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目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者脑白质结构损害与认知功能障碍的相关性。方法选取2014年11月至2015年10月因打鼾于我院就诊的91例患者,根据呼吸暂停低通气指数(AHI)将患者分为单纯鼾症18例,轻度OSAHS组24例,中度OSAHS组21例,重度OSAHS组28例。比较四组研究对象的睡眠呼吸参数、侧脑室周围高信号灶(PVH)评分、简易智能状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分,分析PVH评分和其他参数的相关性。结果重度OSAHS组的AHI及呼吸睡眠参数ODI、RI、TS90%、LSaO_2、MSaO_2与单纯鼾症组、轻度OSAHS组、中度OSAHS组相比较有显著性差异(P<0.05)。重度OSAHS组的PVH评分、MMSE评分、MoCA评分与其他三组相比较,差异具有统计学意义(P<0.05)。PVH评分和MoCA评分、MMSE评分、LSaO_2、MSaO_2呈负相关(P<0.05),和AHI、ODI、RI参数呈正相关(P<0.05)。结论 OSAHS患者的脑白质结构受损和认知功能障碍存在着密切的关联性。
Objective To analyze the correlation between white matter structure impairment and cognitive dysfunction in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods 91 patients with snoring in our hospital from November 2014 to October 2015 were selected. According to apnea-hypopnea index (AHI), patients were divided into simple snoring (18 cases), mild OSAHS group (24 cases), moderate 21 cases in OSAHS group and 28 cases in severe OSAHS group. The sleep breathing parameters, PVH score, MMSE score, Montreal Cognitive Assessment Scale (MoCA) score of the four groups were compared to analyze the correlation between PVH score and other parameters Sex. Results AHI and respiratory sleep parameters ODI, RI, TS90%, LSaO_2, MSaO_2 in severe OSAHS group were significantly different from those in simple OSAHS group, mild OSAHS group and moderate OSAHS group (P <0.05). PVH score, MMSE score and MoCA score in severe OSAHS group were significantly different from those in other three groups (P <0.05). PVH score was negatively correlated with MoCA score, MMSE score, LSaO_2 and MSaO_2 (P <0.05), but positively correlated with AHI, ODI and RI (P <0.05). Conclusion There is a close relationship between impairment of white matter structure and cognitive dysfunction in patients with OSAHS.