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[重度阻塞性睡眠呼吸暂停低通气综合征患者血清S100蛋白及神经元特异性烯醇化酶水平变化及治疗后的意义]

[Serum S100 protein and NSE levels and significance of changes after treatment in patients with severe OSAHS].

作者信息

Feng Xiaohui, Kang Xiaoming, Zhou Fang, Xiao Xuping, Wang Jihua

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Nov;28(21):1665-9.

Abstract

OBJECTIVE

Understand the changes before and after treatment in patients with severe OSAHS serum S100β protein, NSE levels and cognitive function. To investigate the molecular mechanisms of cognitive dysfunction in patients with severe OSAHS. Serum S100β protein, NSE levels and cognitive function were examined before and after the therapy.

METHOD

Select one hundred patients diagnosed as severe OSAHS were included, by polysomnography (PSG) diagnosis of severe OSAHS patients. Determination of serum S100β protein, and NSE levels and theat the same time be MoCA score were checked at after the day after admission, CPAP treatment for the 7th days after CPAP treatment and the 90th day after, comprehensive treatment in these patients for 3 months. Assessment of severe OSAHS patients with serum S100β protein, NSE basic level and MoCA score situation. Comparison of three groups serum S100β protein, NSE levels and MoCA score changes. Serum S100β protein, NSE detection assay (ELISA) method using enzyme-linked immunosorbent.

RESULT

(1) Severe OSAHS patients with serum S100β protein, and NSE levels in severe OSAHS patients were positively correlated with AHI, but negatively correlated with lowest oxygen saturation (LSaO2); (2) MoCA score in patients with severe OSAHS was significantly negatively correlated with AHI, but positively correlated with LSaO2; (3) S100β protein, NSE levels were negatively correlated with MoCA score; (4) Compared with admission, serum S100β protein, and NSE levels in these patients have declined after 7 days CPAP therapy, compared with admission the difference was statistically significant (P < 0.05). After 3 months of comprehensive treatment, patients' serum S100β protein and, NSE levels were significantly decreased, compared with the admission and the 7th days after CPAP treatment. The difference was statistically significant (P < 0.05). (5) After CPAP treatment for 7 days, the MoCA scores were slightly higher, but have there was no statistically significant difference compared with the admission (P > 0.05). After 3 months of comprehensive treatment, MoCA score improved significantly, compared with the admission and 7 days after CPAP treatment the difference was statistically significant (P < 0.05).

CONCLUSION

Comprehensive treatment can reduce serum S100β protein, and NSE levels, and improve MoCA score. Disease severity in patients with OSAHS have a correlation some relative.with the serum S100β protein, NSE levels and MoCA score. Long-term hypoxemia and the structure of sleep disorders may be the cause of elevated serum S100β protein, NSE levels elevated and causes of cognitive dysfunction. Comprehensive treatment can improve patient hypoxemia, correct disorders of sleep structure ,and can improve cognitive function and to improve the quality of life of patients.

摘要

目的

了解重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者治疗前后血清S100β蛋白、神经元特异性烯醇化酶(NSE)水平及认知功能的变化情况。探讨重度OSAHS患者认知功能障碍的分子机制。对患者治疗前后血清S100β蛋白、NSE水平及认知功能进行检测。

方法

选取确诊为重度OSAHS的患者100例,经多导睡眠图(PSG)诊断为重度OSAHS患者。测定血清S100β蛋白、NSE水平并同时于入院后次日、持续气道正压通气(CPAP)治疗7天后、CPAP治疗90天后进行蒙特利尔认知评估量表(MoCA)评分,对这些患者进行3个月的综合治疗。评估重度OSAHS患者血清S100β蛋白、NSE基础水平及MoCA评分情况。比较三组血清S100β蛋白、NSE水平及MoCA评分变化。血清S100β蛋白、NSE检测采用酶联免疫吸附测定法(ELISA)。

结果

(1)重度OSAHS患者血清S100β蛋白、NSE水平与重度OSAHS患者的呼吸暂停低通气指数(AHI)呈正相关,但与最低血氧饱和度(LSaO2)呈负相关;(2)重度OSAHS患者的MoCA评分与AHI呈显著负相关,但与LSaO2呈正相关;(3)S100β蛋白、NSE水平与MoCA评分呈负相关;(4)与入院时相比,这些患者CPAP治疗7天后血清S100β蛋白、NSE水平有所下降,与入院时相比差异有统计学意义(P<0.05)。综合治疗3个月后,患者血清S100β蛋白、NSE水平显著降低,与入院时及CPAP治疗7天后相比差异有统计学意义(P<0.05)。(5)CPAP治疗7天后,MoCA评分略有升高,但与入院时相比差异无统计学意义(P>0.05)。综合治疗3个月后,MoCA评分显著提高,与入院时及CPAP治疗7天后相比差异有统计学意义(P<0.05)。

结论

综合治疗可降低血清S100β蛋白、NSE水平,提高MoCA评分。OSAHS患者疾病严重程度与血清S100β蛋白、NSE水平及MoCA评分有一定相关性。长期低氧血症及睡眠结构紊乱可能是血清S100β蛋白、NSE水平升高及认知功能障碍的原因。综合治疗可改善患者低氧血症,纠正睡眠结构紊乱,进而改善认知功能及提高患者生活质量。

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