阻塞性睡眠呼吸暂停低通气综合征患者血清晚期氧化蛋白产物水平与认知功能的相关性

[Correlation between the serum level of advanced oxidation protein products and the cognitive function in patients with obstructive sleep apnea hypopnea syndrome].

作者信息

Yang Xiu-hong, Liu Xue, Shang Jin, Liu Hui-guo, Xu Yong-jian

机构信息

Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2013 Apr;36(4):274-9.

PMID:23945341

Abstract

OBJECTIVE

To observe the change of the cognitive function and the serum level of advanced oxidation protein products (AOPP) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and then to investigate the correlation between them.

METHODS

Sixty seven patients with OSAHS, 20 healthy controls with matched age, BMI, and education, 15 patients with OSAHS after effective treatment of continuous positive airway pressure (CPAP) with matched age, BMI, and education were enrolled. Polysomnography (PSG), Epworth sleepiness scale (ESS), mini-mental state examination (MMSE), and clock drawing test (CDT) were performed in these groups. The serum level of AOPP, superoxide dismutase (SOD), and malondialdehyde (MDA) were measured.

RESULTS

The MMSE and CDT scores of patients with OSAHS were decreased compared to those in healthy controls [(4.73 ± 0.81) vs (2.69 ± 1.38), (2.85 ± 0.61) vs (1.92 ± 0.62)], but the scores improved after effective CPAP treatment. The serum levels of AOPP [(78 ± 20) vs (117 ± 20) µmol/L] and MDA [(2.9 ± 1.0) vs (6.1 ± 3.0) µmol/L] in patients with OSAHS were increased compared to those in healthy controls, but the levels decreased after effective CPAP treatment. The serum SOD level in patients with OSAHS was decreased compared to that in healthy controls [(89 ± 8) vs (57 ± 9) U/ml], but it was increased after effective CPAP treatment. The MMSE and CDT scores of all the subjects including the 2 groups (the OSAHS group and the effective CPAP-treatment group) were correlated with the results of PSG (baseline SaO2, lowest SaO2, AHI, LA/HT, SLT90%). The serum levels of AOPP, MDA and SOD of all the subjects were also correlated with the results of PSG (lowest SaO2, AHI, LA/HT, SLT90%). The serum levels of AOPP, MDA and SOD of all the subjects were correlated with the MMSE and CDT scores. The serum level of AOPP of all the subjects was also correlated with the serum levels of MDA and SOD.

CONCLUSIONS

Cognitive impairment in patients with OSAHS is correlated with the severity of the disease. AOPP is a useful marker for oxidative stress and protein injury, and closely correlated with the cognitive impairment in patients with OSAHS.

摘要

目的

观察阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者认知功能及血清晚期氧化蛋白产物（AOPP）水平的变化，并探讨二者之间的相关性。

方法

纳入67例OSAHS患者、20例年龄、体重指数（BMI）和受教育程度匹配的健康对照者、15例年龄、BMI和受教育程度匹配且经持续气道正压通气（CPAP）有效治疗后的OSAHS患者。对这些组进行多导睡眠图（PSG）、爱泼华嗜睡量表（ESS）、简易精神状态检查表（MMSE）和画钟试验（CDT）。检测血清AOPP、超氧化物歧化酶（SOD）和丙二醛（MDA）水平。

结果

与健康对照者相比，OSAHS患者的MMSE和CDT评分降低[（4.73±0.81）对（2.69±1.38），（2.85±0.61）对（1.92±0.62）]，但经有效CPAP治疗后评分改善。与健康对照者相比，OSAHS患者的血清AOPP水平[（78±20）对（117±20）µmol/L]和MDA水平[（2.9±1.0）对（6.1±3.0）µmol/L]升高，但经有效CPAP治疗后水平降低。与健康对照者相比，OSAHS患者的血清SOD水平降低[（89±8）对（57±9）U/ml]，但经有效CPAP治疗后升高。包括两组（OSAHS组和有效CPAP治疗组）在内的所有受试者的MMSE和CDT评分均与PSG结果（基线SaO₂、最低SaO₂、呼吸暂停低通气指数（AHI）、左房内径/身高（LA/HT）、睡眠时血氧饱和度低于90%的时间（SLT90%））相关。所有受试者的血清AOPP、MDA和SOD水平也与PSG结果（最低SaO₂、AHI、LA/HT、SLT90%）相关。所有受试者的血清AOPP、MDA和SOD水平与MMSE和CDT评分相关。所有受试者的血清AOPP水平也与MDA和SOD水平相关。