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血清NPY和IGF-1在成人OSAHS中的表达及与患者认知功能的关系*
王萍,唐宋琪,陈应奇,曾晓玲,周承智
0
(海口市人民医院健康管理体检部;海南医学院中医学院)
摘要:
【摘要】 目的 探讨血清神经肽Y(NPY)和胰岛素样生长因子-1(IGF-1) 在成人阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中的表达情况,并分析其与患者认知功能的关系。 方法 选取2017年1月~2019年1月于海口市人民医院经全脑电多导睡眠监测仪(PSG)确诊为OSAHS的成人患者180例作为研究对象,根据蒙特利尔认知评估量表(MoCA)将其分为认知功能障碍组(n=100)和认知功能正常组(n=80),并选取同期100例体检正常成年人(经PSG排除OSAHS)作为对照组。比较各组血清NPY和IGF-1差异;绘制ROC曲线图分析NPY和IGF-1对OSAHS的临床价值;采用Pearson相关法分析血清NPY和IGF-1与OSAHS认知功能严重程度(MoCA评分)的关系;用Logistic多因素回归分析OSAHS认知功能障碍的危险因素。 结果 3组血清NPY和IGF1比较差异有统计学意义(P<0.05);认知功能障碍组NPY高于认知功能正常组和对照组(P<0.05);认知功能障碍组IGF1低于认知功能正常组和对照组。ROC曲线发现,血清NPY和IGF-1对OSAHS均有一定诊断价值,对OSAHS认知功能障碍具有一定鉴别诊断价值,两者联合可明显增加其效能。Pearson相关分析显示,血清NPY与MoCA评分呈负相关(r=-0.608,P=0.023);血清IGF-1与MoCA评分呈正相关(r=0.742,P=0.001)。Logistic多因素回归分析显示,病程、血清NPY和IGF-1是OSAHS认知功能障碍的独立危险因素(P<0.05)。 结论 成人OSAHS患者血清NPY和IGF-1表达异常,与认知功能密切相关,其有望成为OSAHS诊断及认知功能障碍鉴别诊断的有效指标。
关键词:  阻塞性睡眠呼吸暂停低通气综合征  认知功能  神经肽Y  胰岛素样生长因子-1  临床价值
DOI:
基金项目:国家自然科学基金资助项目(81860840)
Expression of serum NPY and IGF-1 in adult OSAHS and their relationship with cognitive function
WANG Ping,TANG Songqi,CHEN Yingqi,ZENG Xiaoling,ZHOU Chengzhi
(Department of Health Management, The People′s Hospital of Haikou;College of Chinese Medicine, Hainan Medical College)
Abstract:
【Abstract】 Objective To investigate the expression of serum neuropeptide Y (NPY) and insulinlike growth factor-1 (IGF-1) in adult obstructive sleep apneahypopnea syndrome (OSAHS) and analyze their relationship with cognitive function. Methods 180 adult patients diagnosed as OSAHS by PSG in Haikou People's Hospital from January 2017 to January 2019 were selected as the study objects. According to the Montreal Cognitive Assessment Scale (MoCA), they were divided into cognitive dysfunction group (n=100) and recognition function normal group (n=80). 100 healthy adults (excluding OSAHS by PSG) were selected as the subjects Control group. The differences of serum NPY and IGF-1 in each group were compared. The clinical value of NPY and IGF-1 to OSAHS was analyzed by ROC curve. Pearson correlation method was used to analyze the relationship between serum NPY and IGF-1 and the severity of cognitive function (MoCA score) of OSAHS. Logistic regression was used to analyze the risk factors of cognitive impairment in OSAHS. Results The difference of serum NPY and IGF-1 between the three groups was statistically significant (P<0.05). NPY of cognitive dysfunction group was higher than that of normal cognitive function group and control group (P<0.05). IGF-1 in cognitive dysfunction group was lower than that in normal cognitive function group and control group. The ROC curve showed that serum NPY and IGF-1 had a certain diagnostic value for OSAHS, and had a certain differential diagnostic value for cognitive dysfunction of OSAHS. The combination of the two could have a significant effect. Pearson correlation analysis showed that serum NPY was negatively correlated with MOCA score (r=-0.608, P=0.023). There was a positive correlation between IGF 1 and MOCA score (r=0.742, P=0.001). Logistic regression analysis showed that the course of disease, serum NPY and IGF 1 were the independent risk factors (P<0.05). Conclusion The abnormal expression of NPY and IGF-1 in serum of adult OSAHS is closely related to the cognitive function of patients, which is expected to be an effective index for the diagnosis of OSAHS and the differential diagnosis of cognitive dysfunction.
Key words:  Obstructive sleep apnea hypopnea syndrome  Cognitive function  Neuropeptide Y  Insulin like growth factor-1  Clinical value

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