老年阻塞性睡眠呼吸暂停综合征患者认知功能评估

目的探讨老年阻塞性睡眠呼吸暂停综合征（OSAS）患者的认知状况,及其与睡眠结构紊乱和低氧血症之间的关系。方法受试者分为OSAS组（n=26）及对照组（n=16）,均进行多导睡眠图（PSG）、简易智能精神状态量表（MMSE）和事件相关电位（ERP）检测。结果 OSAS组Ⅲ＋Ⅳ期和REM期睡眠时间比例、最低及平均血氧饱和度明显减少（P〈0.05）,醒觉次数及睡眠呼吸紊乱指数（AHI）明显增加（P〈0.05）;OSAS组MMSE总分显著低于对照组（P〈0.05）,且MMSE总分与AHI呈显著负相关（r=-0.498,P〈0.05）,与平均SaO_2及最低SaO_2呈显著正相关（r分别为0.583和0.441,P均〈0.05）;OSAS组P300潜伏期显著长于对照组（P〈0.05）,P300潜伏期与MMSE总分呈显著负相关（r=-0.512,P〈0.05）。结论老年OSAS患者存在认知功能损害,夜间低氧血症可能起重要作用。

Cognitive impairment in the elderly patients with obstructive sleep apnea syndrome

Objective To explore the relationship between sleep architecture changes and cognitive impairment in elderly patients with obstructive sleep apnea syndrome（OSAS）.Methods The two groups,consisting of the OSAS group（n = 26） and control group（n = 16）,were tested by polysomnography（PSG）,mini mental state exa mination（MMSE） and event related potential（ERP）.Results The OSAS group were decreased significantly in delta sleep ratio,minimum and mean saturation of blood oxygen（P0.05）,and increased in apnea hyponea index （AHI） and frequency of arousal during sleep（P0.05）.The scores of MMSE in OSAS group were significantly lower than that in the control group（P0.05）.Furthermore,the score of MMSE was significantly negatively correlated with AHI（r = -0.498,P0.05）,and was significantly positively correlated with mean and minimum saturation of blood oxygen（r =0.583 and r =0.441,P0.05）.In patients with OSAS,the latency of P300 increased significantly compared with the control group（P0.05）,and the latency of P300 was significantly negatively correlated with the score of MMSE（r = -0.512,P0.05）.Conclusion It demonstrated that the elderly patients with OSAS had cognitive impairment,and nocturnal hypoxemia may play an important role.