摘要
目的 研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清内分泌素(Endocan)、亲环素A(CyPA)、白脂素(asprosin)水平与病情及认知功能的关系.方法 收集2021年1月～2023年12月石家庄市第三医院收治的99例OSAHS患者,根据呼吸暂停低通气指数(AHI)分为轻度组(n=29)、中度组(n=45)和重度组(n=25).采用ELISA方法检测血清Endocan、CyPA、asprosin水平,多因素Logistic回归分析患者病情程度的影响因素,绘制受试者工作特征(ROC)曲线分析,血清Endocan、CyPA、asprosin对患者认知功能的诊断价值,Spearman分析血清Endocan、CyPA、asprosin与病情程度及认知功能的相关性.结果 与轻度组相比,中、重度组患者血清Endocan、CyPA、asprosin水平显著升高(P<0.05),且重度组血清Endocan、CyPA、asprosin水平较中度组显著升高(P<0.05);三组患者的AHI、Epworth嗜睡量表(ESS)评分、部分睡眠相关参数之间差异有统计学意义(P<0.05);进一步分析,平均血氧饱和度(mean oxygen saturation,MSaO2)为影响患者病情程度的保护因素(P<0.05),AHI、血清Endocan、CyPA、asprosin水平均为影响患者病情程度的危险因素(P<0.05);认知障碍患者的血清Endocan、CyPA、asprosin水平显著高于认知正常患者,蒙特利尔认知评估量表(MoCA)评分低于认知正常组(P<0.05);血清Endocan、CyPA、asprosin以及联合诊断患者认知功能障碍的AUC分别为0.889、0.893、0.861、0.974,且联合诊断显著优于Endocan(Z=2.832,P=0.005)、CyPA(Z=2.907,P=0.004)、asprosin(Z=3.225,P=0.001)单独诊断;血清Endocan、CyPA、asprosin与AHI呈正相关,与MoCA评分呈负相关(P<0.05).结论 在重度OSAHS患者以及认知功能障碍患者中,血清Endocan、CyPA、asprosin水平均升高,且对患者病情程度及认知功能具有一定辅助诊断价值.
Abstract
OBJECTIVE To study and analyze the relationship between serum levels of Endocan,Cyclophilic A (CyPA),and asprosin with the condition severity and cognitive function in patients with obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS From November 2021 to December 2023,99 OSAHS patients who visited our hospital were collected and separated into mild group(n=29),moderate group(n=45),and severe group(n=25) based on the apnea hypopnea index(AHI). ELISA method was applied to detect serum levels of Endocan,CyPA,and asprosin. Multivariate logistic regression was used to analyze the influencing factors of severity of condition. ROC curve was plotted to analyze the diagnostic value of serum Endocan,CyPA,and asprosin for cognitive function in OSAHS patients. Spearman rank correlation was applied to analyze the correlation between serum Endocan,CyPA,asprosin,with severity of condition,cognitive function. RESULTS Compared with the mild group,the serum levels of Endocan,CyPA,and asprosin were obviously increased in the moderate and severe groups(P<0.05),and the serum levels of Endocan,CyPA,and asprosin in the severe group were obviously increased compared to the moderate group(P<0.05). There were statistically obvious differences in AHI,Epworth sleepiness scale(ESS) scores,and some sleep related parameters among the three groups(P<0.05). Further analysis revealed that mean blood oxygen saturation(MSaO2) was a protective factor affecting the severity of condition(P<0.05),while AHI,serum Endocan,CyPA,and asprosin levels were all risk factors affecting the severity of condition(P<0.05). The serum levels of Endocan,CyPA,and asprosin in patients with cognitive impaired were obviously higher than those in patients with normal cognition,and the MoCA score was lower than that in patients with normal cognition(P<0.05). The AUC of serum Endocan,CyPA,asprosin,and combined diagnosis for cognitive impairment in patients was 0.889,0.893,0.861,and 0.974,respectively,and the combined diagnosis was obviously better than individual diagnosis of Endocan(Z=2.832,P=0.005),CyPA(Z=2.907,P=0.004),and asprosin(Z=3.225,P=0.001). Serum Endocan,CyPA,and asprosin were positively correlated with AHI and negatively correlated with MoCA score(P<0.05). CONCLUSION In patients with severe OSAHS and cognitive impairment,serum Endocan,CyPA,and asprosin levels are all increased,and they have certain auxiliary diagnostic value for the severity of condition and cognitive function.
维普
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