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| 阻塞性睡眠呼吸暂停低通气综合征患者血清NPY、HSP-70、GABA与睡眠结构参数的相关性及其认知功能障碍的影响因素分析 |
| Correlation of serum NPY, HSP-70, GABA and sleep structure parameters and influencing factors analysis of cognitive dysfunction in patients with obstructive sleep apnea hypopnea syndrome |
| 投稿时间：2022-10-20 修订日期：2022-10-20 |
| DOI： |
| 中文关键词: 阻塞性睡眠呼吸暂停低通气综合征 认知功能障碍 神经肽Y 热休克蛋白70 γ-氨基丁酸 睡眠结构 |
| 英文关键词: Obstructive sleep apnea hypopnea syndrome Cognitive dysfunction Neuropeptide Y Heat shock protein 70 γ-aminobutyric acid Sleep structure |
| 基金项目:江苏省卫生健康委科研课题（H2018013） |
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| 中文摘要: |
| 目的 探讨不同病情阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清神经肽Y（NPY）、热休克蛋白70（HSP-70）、γ-氨基丁酸（GABA）水平的差异，分析其与睡眠结构参数的相关性以及OSAHS患者认知功能障碍的危险因素。方法 选择2019年3月至2022年3月南通大学附属南京江北医院和江苏省人民医院收治的122例OSAHS患者，根据睡眠呼吸暂停低通气指数（AHI）和夜间最低血氧饱和度（SPO2）将OSAHS患者分为轻度组32例、中度组54例、重度组36例，根据蒙特利尔认知评估量表（MoCA）将其分为认知功能障碍组（＜26分，71例）和认知功能正常组（≥26分，51例）。检测血清NPY、HSP-70、GABA水平，Pearson相关分析血清NPY、HSP-70、GABA与OSAHS患者睡眠结构参数的相关性。单因素和多因素Logistic回归分析OSAHS发生认知功能障碍的危险因素。结果 重度组血清NPY、HSP-70水平、快波睡眠次数、入睡后觉醒次数、快波睡眠百分比高于中度组、轻度组（P＜0.05），血清GABA水平、慢波睡眠次数、慢波睡眠百分比低于中度组、轻度组（P＜0.05）。OSAHS患者血清NPY、HSP-70水平与快波睡眠次数、入睡后觉醒次数、快波睡眠百分比呈正相关（P＜0.05），与慢波睡眠次数、慢波睡眠百分比呈负相关（P＜0.05）；血清GABA水平与快波睡眠次数、入睡后觉醒次数、快波睡眠百分比呈负相关（P＜0.05），与慢波睡眠次数、慢波睡眠百分比呈正相关（P＜0.05）。重度OSAHS、入睡后觉醒次数增加、NPY（升高）、HSP-70（升高）是OSAHS患者认知功能障碍的危险因素（P＜0.05），GABA（升高）是保护因素（P＜0.05）。结论 血清NPY、HSP -70水平升高，GABA水平下降与OSAHS患者睡眠结构紊乱和认知功能障碍有关，检测血清NPY、HSP-70、GABA可以辅助评估患者的睡眠情况和认知功能。 |
| 英文摘要: |
| Objective To investigate the differences of serum neuropeptide Y (NPY), heat shock protein 70 (HSP-70) and γ-aminobutyric acid (GABA) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with different conditions,and to analyze their correlation with sleep structure parameters and the risk factors of cognitive dysfunction in patients with OSAHS. Methods 122 patients with OSAHS who were admitted to Nanjing Jiangbei Hospital Affiliated to Nantong University and Jiangsu Provincial People''s Hospital from March 2019 to March 2022 were selected. According to the sleep apnea hypopnea index (AHI) and the lowest oxygen saturation (SPO2) at night, patients with OSAHS were divided into mild group with 32 cases, moderate group with 54 cases and severe group with 36 cases. According to the Montreal Cognitive Assessment Scale (MoCA), they were divided into cognitive dysfunction group (less than 26 scores, 71 cases) and normal cognitive function group (greater than or equal to 26 scores, 51 cases). The serum NPY, HSP-70, GABA levels were detected. Pearson correlation analysis was performed to analyze the correlation between serum NPY, HSP-70, GABA and sleep structure parameters in patients with OSAHS. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of cognitive dysfunction in OSAHS. Results The serum NPY, HSP-70 levels, times of fast wave sleep, times of awakening after falling asleep and percentage of fast wave sleep in the severe group were higher than those in the moderate group and mild group (P＜0.05), while the serum GABA level, times of slow wave sleep and percentage of slow wave sleep were lower than those in the moderate group and mild group (P＜0.05). The serum NPY and HSP-70 levels in patients with OSAHS were positively correlated with the times of fast wave sleep, the times of awakening after falling asleep and the percentage of fast wave sleep (P＜0.05), and negatively correlated with the times of slow wave sleep and the percentage of slow wave sleep (P＜0.05). The serum GABA level was negatively correlated with the times of fast wave sleep, the times of awakening after falling asleep and the percentage of fast wave sleep (P＜0.05), and positively correlated with the times of slow wave sleep and the percentage of slow wave sleep (P＜0.05). Severe OSAHS, increased times of awakening after falling asleep, NPY (increased) and HSP-70 (increased) were risk factors for cognitive dysfunction in patients with OSAHS (P＜0.05), while GABA (increased) was a protective factor (P＜0.05). Conclusion The increased serum NPY and HSP-70 levels and the decreased GABA level are associated with sleep structure disorder and cognitive dysfunction in patients with OSAHS. The detection of serum NPY, HSP-70 and GABA can assist in evaluating sleep and cognitive function of patients. |
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