同期多平面手术对中青年中-重度OSAHS患者血清氧化应激水平和认知功能的影响

王青云; 陈锐; 曹忠胜; 袁辉; 赵婉君; 李小波; 邬晓帆; 辛洁; 刘志勇; 李文全

doi:10.13201/j.issn.1001-1781.2015.24.009

同期多平面手术对中青年中-重度OSAHS患者血清氧化应激水平和认知功能的影响

- 1. 苏州大学附属第二医院耳鼻咽喉科(江苏苏州, 215000);
- 2. 苏州大学附属第二医院睡眠中心

详细信息

通讯作者: 曹忠胜,E-mail:cao4018@163.com

中图分类号: R563.8

收稿日期: 2015-08-07

Effects of simultaneous multi-level surgery intervention on the changes of the oxidative stress and the cognitive function in young and middle-aged patients with Moderate-severe obstructive sleep apnea hypopnea syndrome

- 1 Department of Otorhinolaryngology, the Second Affiliated Hospital of Soochow University, Suzhou, 215000, China;
- 2 Sleep Center, Department of Respiratory Medicine, the Second Affiliated Hospital of Soochow University

More Information

Corresponding author: CAO Zhongsheng, E-mail: cao4018@163.com

Received Date: 07 August 2015

摘要

摘要: 目的: 探讨同期多平面手术对中青年中-重度OSAHS患者血清氧化应激水平和认知功能的影响。方法: 116例中青年中-重度OSAHS患者接受同期多平面手术治疗。术前及术后6个月测定PSG相关指标,血清丙二醛(MDA)、晚期蛋白氧化产物(AOPP)和8-异前列腺素F2α(8-iso-PGF2α)水平,利用MoCA、MMSE和ESS量表评估认知功能和白天嗜睡程度,并进行统计学分析。结果: ①术后6个月AHI、TS90%、LSaO₂数值均较术前明显改善(P<0.01)。全部患者未出现严重并发症。②MoCA、MMSE评分分别为(23.52±2.64)分和(26.54±1.07)分,OSAHS患者术前存在认知功能障碍,MoCA评分与AHI、TS90%、MDA、AOPP和8-iso-PGF2α呈负相关,与LSaO₂呈正相关(r分别为-0.233、-0.190、-0.256、-0.247、-0.221和0.215,P<0.05)。认知功能损伤主要表现在视空间与执行功能、记忆与延迟回忆(主要以短期记忆为主)方面。③与术前相比,术后MoCA和MMSE评分均升高(P<0.05);MDA、AOPP和8-iso-PGF2α水平及ESS评分均显著降低(P<0.05)。且术后患者MoCA评分分别与MDA、AOPP、8-iso-PGF2α、AHI、TS90%呈负相关,与LSaO₂呈正相关(r分别为-0.495、-0.463、-0.397、-0.332、-0.292和0.336,P<0.05)。结论: 中青年中-重度OSAHS患者认知功能障碍与体内氧化应激水平密切相关,同期多平面手术通过降低全身氧化应激水平进而改善认知功能。
- 睡眠呼吸暂停低通气综合征 /
- 阻塞性 /
- 外科手术 /
- 氧化应激 /
- 认知
Abstract: Objective To explore the effects of simultaneous multi-level surgery intervention on the changes of the oxidative stress and the cognitive function in young and middle-aged patients with moderate-severe OSAHS.Method: One hundred and sixteen young and middle-aged patients with moderate-severe OSAHS received simultaneous multi-level surgery.PSG,malondialdehyde (MDA),advanced oxidation protein products (AOPP) and 8-isoprostaneF2α(8-iso-PGF2α) were tested, together with the evaluation of the questionnaires of Montreal cognitive assessment (MoCA),mini-mental state examination (MMSE) and Epworth sleepiness scale (ESS) before and 6 months after surgery.Result: ① The AHI,TS90% and LSaO₂ were all improved significantly 6 months after operation. No severe complications were observed in any patient. ②The preoperative MoCA and MMSE scores were (23.52±2.64) and (26.54±1.07),respectively. The cognitive impairment were detected in OSAHS patients. MoCA was negatively correlated with AHI,TS90%,MDA,AOPP and 8-iso-PGF2α, while positively correlated with LSaO₂(P<0.05,r=-0.233,-0.190,-0.256,-0.247,-0.221 and 0.215,respectively). Cognitive impairment was mainly manifested as disorder in the visual space and executive function, memory and delayed recall (mainly short-term memory). ③ MoCA and MMSE scores were both increased (P<0.05) after the operation. MoCA showed negative correlations with MDA,AOPP,8-iso-PGF2α,AHI and TS90%,and positive correlation with LSaO₂(P<0.05,r=-0.495,-0.463,-0.397,-0.332,-0.292 and 0.336,respectively).Conclusion: Oxidative stress and cognitive dysfunction are closely related in young and middle-aged patients with Moderate-severe OSAHS. Oxidative stress may play an important role in cognitive function of young and middle-aged patients with Moderate-severe OSAHS.Multi-level surgery can improve oxidative stress so that to improve cognitive impairment.
- sleep apnea-hypopnea syndrome /
- obstructive /
- surgical procedures /
- operative /
- oxidative stress

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