STOP-Bang问卷与中重度阻塞性睡眠呼吸暂停低通气综合征患者认知功能的关系研究

目的研究STOP-Bang问卷与中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者认知功能的关系,以探讨其临床应用价值。方法纳入经多导睡眠监测确诊的中重度OSAHS患者94例,根据STOP-Bang问卷将患者分为重度组(44例)和中度组(50例),并用简易智能状态量表(MMSE)评价患者的认知功能,运用Pearson相关分析和ROC曲线评价STOP-Bang问卷结果与认知功能的关系。结果与中度组患者比较,重度组患者高血压比例较高(59.1%vs.36.0%,P=0.03),体质量指数(30.3±2.5)kg/m²vs.(28.5±1.7)kg/m2vs.(28.5±1.7)kg/m²]、呼吸暂停低通气指数(51.2±2.4)次/h vs.(26.5±3.5)次/h]和STOP-Bang总得分较高(5.6±1.2 vs.2.3±0.6),而最低氧饱和度(62.7+4.6)%vs.(78.2±3.8)%]、快眼动睡眠比例(4.2±0.7)%vs.(5.3±1.3)%]和MMSE评分较低(22.6±1.2)分vs.(27.3±0.6)分],差异均有统计学意义(P<0.01);重度组患者的记忆力(1.2±0.4)分vs.(2.2±0.5)分]、注意力(2.5±0.9)分vs.(3.4±1.1)分]和回忆力(1.2±0.7)分vs.(2.4±0.3)分]评分均显著下降,差异均有统计学意义(P<0.01);STOP-Bang问卷得分与认知功能呈负相关(r=-0.69,P<0.01);其预测认知功能障碍的敏感度为82.4%,特异度为65.8%,曲线下面积为0.72(95%C1 0.612]、呼吸暂停低通气指数(51.2±2.4)次/h vs.(26.5±3.5)次/h]和STOP-Bang总得分较高(5.6±1.2 vs.2.3±0.6),而最低氧饱和度(62.7+4.6)%vs.(78.2±3.8)%]、快眼动睡眠比例(4.2±0.7)%vs.(5.3±1.3)%]和MMSE评分较低(22.6±1.2)分vs.(27.3±0.6)分],差异均有统计学意义(P<0.01);重度组患者的记忆力(1.2±0.4)分vs.(2.2±0.5)分]、注意力(2.5±0.9)分vs.(3.4±1.1)分]和回忆力(1.2±0.7)分vs.(2.4±0.3)分]评分均显著下降,差异均有统计学意义(P<0.01);STOP-Bang问卷得分与认知功能呈负相关(r=-0.69,P<0.01);其预测认知功能障碍的敏感度为82.4%,特异度为65.8%,曲线下面积为0.72(95%C1 0.61⁰.82,P<0.01)。结论在中重度OSAHS患者中,STOP-Bang问卷结果与患者的认知功能明显相关,对认知功能具有一定的预测价值,

The relationship between STOP-Bang questionnaire and cognitive function in patients with moderate to severe obstructive sleep apnea hypopnea syndrome

Objective To investigate the relationship between STOP-Bang questionnaire and cognitive function in patients with moderate to severe obstructive sleep apnea hypopnea syndrome （OSAHS） , and to evaluate its clinical application value. Methods Ninety-four patients with severe OSAHS were confirmed by polysomnogram were enrolled, according to the STOP-Bang questionnaire, they were divided into severe group （44 cases） and moderate group （50 cases）, and mini mental status scale （MMSE） were used to assess cognitive function in patients, the relationship between STOP-Bang questionnaire results and cognitive function were analyzed by Pearson correlation analysis and ROC curve. Results Comparing with the patients of moderate group, patients in severe group with a higher proportion of hypertension （59.1% vs. 36.0%, P=0.03 ） , body mass index （30.3 ±2.5） kg/m^2 vs. （28.5± 1.7） kg/m^2 ], apnea hypopnea index （51.2 ± 2.4） / h vs. （ 26.5 ± 3.5 ） /h ] and STOP-Bang total scores （5.6 ± 1.2 vs. 2.3 ±0.6）, while the low oxygen saturation （ 62.7± 4.6 ） % vs. （78.2 ± 3.8）%, rapid eye movement sleep （4.2±0.7）% vs. （5.3 ±1.3）%] and lowerMnSE score （22.6± 1.2） vs. （27.3 ±0.6） ], the differences were statistically significant （ P 〈0.01 ） ; severe group patients＇memory （ 1.2 ±0.4） vs. （2.2±0.5）],attention（2.5±0.9） vs. （3.4±1.1）] andrecall （1.2±0.7） vs. （2.4±0.3）] were significantly decreased, the differences were statistically significant （ P 〈 0.01 ） ; negative correlation with cognitive function score questionnaire （ r = - 0.69, P 〈 0.01 ） ; its predicted cognitive dysfunction in the sensitivity was 82.4% , specificity was 65.8%, the area under the curve was 0.72 （95% CI 0.61 - 0 . 82, P 〈 0.01 ）. Conclusion In severe OSAHS patients, STOP-Bang questionnaire results was significantly related to cognitive function, has some predictive value of cognitive function.