目的: 探讨阻塞性睡眠呼吸暂停(OSA)与肺功能及认知损害的相关性,探究OSA发生肺功能下降、认知损害的可能机制。方法: 收集2021年1月至2022年6月期间就诊并完成多导睡眠监测(polysomnography,PSG)确诊为阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的46例患者,据呼吸暂停低通气指数(AHI)分为轻中度组(n=20)和重度组(n=26),选取健康者(n=23)作为对照组,对研究对象的一般资料、PSG、肺功能、血气分析、蒙特利尔认知评估量表(MoCA)评分等数据结果进行对比和统计分析。结果: 重度组肺活量(VC)、第1秒用力呼气容积占预计值百分比(FEV1%pred)、1秒率(FEV1/FVC%)、补呼吸气量(ERV)、功能残气量(FRC)、中段用力呼气流速(MMEF%)、50%用力呼气流速(FEF50%)均低于轻中度组及健康组(P＜0.05);重度组氧分压(PaO2)较轻中度组及健康组下降(P＜0.05);MoCA评分在三组间比较差异有统计学意义(P＜0.05)。相关分析显示,PaO2与AHI、最长呼吸暂停时间呈负相关,与LSaO2呈正相关。结论: OSA患者肺功能及认知能力受损,重度OSA患者肺功能及认知能力下降更明显,夜间缺氧及日间PaO2较低在OSA患者肺功能下降及认知损害机制中起到重要作用。
Objective: To investigate the correlation between obstructive sleep apnea (OSA) and lung function and cognitive impairment, and to investigate the possible mechanisms of lung function decline and cognitive impairment caused by OSA. Methods: Forty-six patients with obstructive sleep apnea hypopnea syndrome (OSAHS) diagnosed by polysomnography (PSG) from January 2021 to June 2022 were collected. According to the apnea hypopnea index (AHI), they were divided into mild to moderate group (n=20) and severe group (n=26). Healthy subjects (n=23) were selected as the control group. The general data, PSG, lung function, blood gas analysis, and Montreal Cognitive Assessment Scale (MoCA) scores of the subjects were compared and statistically analyzed. Results: The vital capacity (VC), forced expiratory volume in 1 second percent predicted (FEV1%pred), forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), expiratory reserve volume (ERV), functional residual capacity (FRC), maximum mid-expiratory flow rate (MMEF%) and 50% forced expiratory flow rate (FEF50%) in the severe group were lower than those in the mild-to-moderate group and the healthy group (P＜0.05). The partial pressure of oxygen (PaO2) in the severe group was lower than that in the mild to moderate group and the healthy group (P＜0.05). There was significant difference in MoCA score among the three groups (P＜0.05). Correlation analysis showed that PaO2 was negatively correlated with AHI and the longest apnea time, and positively correlated with LSaO2. Conclusion: The lung function and cognitive ability of OSA patients are impaired, and the lung function and cognitive ability of patients with severe OSA are more obvious. Night hypoxia and low daytime PaO2 play an important role in the mechanism of lung function decline and cognitive impairment in OSA patients.
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