呼吸暂停低通气指数<5的人群脑白质影像学和认知功能观察

White matter imaging and cognitive function in patients with apnea-hypopnea index <5

摘要:

目的 探讨呼吸暂停低通气指数（AHI）<5的人群脑白质影像学和认知功能改变。方法 收集2017年6月至2019年12月在长沙市第一医院收治的AHI<5且完善多导睡眠监测（PSG）的患者101例，采用改良Scheltens量表对其脑白质病变进行评分。采用蒙特利尔认知功能评估量表（MOCA）评估患者的认知功能，完成MOCA评估的49例。根据AHI数值将患者分别分为以下5组：0 ≤ AHI<1（A/a组）；1 ≤ AHI<2（B/b组）；2 ≤ AHI<3（C/c组）；3 ≤ AHI<4（D/d组）；4 ≤ AHI<5（E/e组）。结果 比较各组深部白质病变、脑室周围白质以及总的脑白质病变评分，差异均无统计学意义（P>0.05）。已完成MOCA评估的各组在MOCA总分及其子领域比较中，延迟回忆评分随AHI数值增加呈下降趋势，差异有统计学意义（P<0.05），且4 ≤ AHI<5组下降更明显。合并a~d组的延迟回忆值与e组进行比较，差异有统计学意义（P<0.05）。结论 AHI<5的患者，会出现延迟回忆受损；但脑白质病变在常规磁共振检测中不敏感。

Abstract:

Objective To explore white matter and cognitive function changes in patients with an apnea-hypopnea index (AHI) of less than 5.Methods We selected 101 patients with AHI <5 undergoing polysomnography in the First Hospital of Changsha from June 2017 to December 2019. White matter lesions were scored by the modified Scheltens scale. Cognitive function was assessed by the Montreal Cognitive Assessment (MoCA), and 49 patients completed the MoCA scale. The patients were divided into five groups:0 ≤ AHI<1 (group A/a), 1 ≤ AHI<2 (group B/b), 2 ≤ AHI<3 (group C/c), 3 ≤ AHI<4 (group D/d), and 4 ≤ AHI<5 (group E/e).Results There were no significant differences in the scores for deep white matter lesions, periventricular white matter lesions, and total white matter lesions between the five groups (P>0.05). For comparisons of the scores for MoCA and its domains, the score for delayed recall showed a downward trend with increasing AHI (P<0.05), with the greatest drop in group E/e; there was a significant difference in delayed recall score between patients in the first four groups and those in the last group (P<0.05).Conclusions Patients with AHI <5 have impaired delayed memory and have no obvious white matter lesions on conventional magnetic resonance imaging.