Lin Ying Ni, Zhou Li Na, Zhang Xiu Juan, Li Qing Yun, Wang Qiong, Xu Hua Jun
Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
Sleep Breath. 2016 Mar;20(1):51-9. doi: 10.1007/s11325-015-1183-1. Epub 2015 Apr 24.
Little is known about combined effect of obstructive sleep apnea (OSA) and chronic smoking on cognitive impairment. We aimed to determine whether smoking synergizes with OSA in deteriorating cognitive function and whether smoking cessation contributes to cognitive benefits.
One hundred and eighteen male patients were enrolled in the study and asked to complete neurocognitive function tests including Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), clock drawing test (CDT), and verbal fluency test (VFT). Variables of those neurocognitive function tests were analyzed with two factors: OSA and smoking.
After adjustment of potential confounding factors, an OSA-by-smoking interaction was found in CDT-C scores and a main smoking effect were showed in MoCA scores. Smoking patients with OSA had the worst performance in the four tests compared with the other three groups (smoking patients without OSA, non-smoking patients with and without OSA). Ex-smokers with OSA tended to perform better than current smokers, but still worse than never-smokers with OSA in those tests.
The results suggested that the coexistence of OSA and chronic smoking resulted in more pronounced cognitive deficits than either factor along. Smoking cessation may benefit cognitive function to some extents in patients with OSA.
关于阻塞性睡眠呼吸暂停（OSA）与长期吸烟对认知功能损害的联合影响，目前所知甚少。我们旨在确定吸烟是否会与OSA协同作用导致认知功能恶化，以及戒烟是否有助于改善认知功能。
118名男性患者参与了本研究，并被要求完成神经认知功能测试，包括简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、画钟试验（CDT）和语言流畅性测试（VFT）。这些神经认知功能测试的变量按照两个因素进行分析：OSA和吸烟。
在调整潜在混杂因素后，发现在CDT-C评分中存在OSA与吸烟的交互作用，在MoCA评分中显示出吸烟的主效应。与其他三组（不伴有OSA的吸烟患者、伴有和不伴有OSA的非吸烟患者）相比，伴有OSA的吸烟患者在这四项测试中表现最差。伴有OSA的戒烟者在这些测试中的表现往往优于目前仍在吸烟的患者，但仍比伴有OSA的从不吸烟者差。
结果表明，OSA与长期吸烟并存导致的认知缺陷比单一因素更为明显。戒烟可能在一定程度上有益于OSA患者的认知功能。
