文章摘要
王迪,刘平闯,季磊,等.持续气道正压通气对阻塞性睡眠呼吸暂停病人认知及血清神经丝轻链蛋白、 Tau蛋白的影响[J].安徽医药,2025,29(5):945-949.
持续气道正压通气对阻塞性睡眠呼吸暂停病人认知及血清神经丝轻链蛋白、 Tau蛋白的影响
Effects of continuous positive airway pressure on cognition and serum NfL and Tau protein in patients with obstructive sleep apnea
  
DOI:10.3969/j.issn.1009-6469.2025.05.018
中文关键词: 睡眠呼吸暂停,阻塞性  连续气道正压通气  认知  神经丝轻链蛋白  Tau蛋白
英文关键词: Sleep apnea,obstructive  Continuous positive airway pressure  Cognition  NfL  Tau protein
基金项目:江苏省六大人才高峰项目( WSN-081);江苏省研究生科研与实践创新计划项目( SJCX23_1386)
作者单位
王迪 徐州医科大学研究生院江苏徐州221000 
刘平闯 徐州医科大学研究生院江苏徐州221000 
季磊 徐州医科大学附属医院呼吸与危重症医学科江苏徐州 221004 
嵇桂娟 徐州医科大学附属医院呼吸与危重症医学科江苏徐州 221004 
赵玲 徐州医科大学附属医院呼吸与危重症医学科江苏徐州 221004 
陈碧 徐州医科大学附属医院呼吸与危重症医学科江苏徐州 221004 
张文辉 徐州医科大学附属医院呼吸与危重症医学科江苏徐州 221004 
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中文摘要:
      目的分析阻塞性睡眠呼吸暂停( OSA)病人认知情况,研究持续气道正压通气( CPAP)对 OSA病人认知及血清神经丝轻链蛋白( NfL)、 Tau蛋白的影响。方法选取 2022年 3月至 2023年 5月徐州医科大学附属医院呼吸睡眠监测中心收治的 90例 OSA病人,根据呼吸暂停低通气指数( AHI)分为轻度组( 5~15次/小时) 26例、中度组( >15~30次/小时) 31例、重度组( >30次/小时) 33例,另外选取同期徐州医科大学附属医院健康体检者 30例作为对照组。采用蒙特利尔认知评估量表( MoCA)、简易智能状态评价量表(MMSE)评估认知功能,酶联免疫吸附分析( ELISA)检测血清 NfL、Tau蛋白水平,中重度病人给予 3个月 CPAP治疗,比较治疗前后 OSA病人认知及血清 NfL、Tau蛋白的变化。结果与对照组相比, OSA组轻、中、重度组 MoCA[( 24.65±3.13)分、(23.69±4.34)分、(21.94±3.26)分比( 27.20±1.29)分]、 MMSE评分[( 25.23±3.43)分、(24.53±2.14)分、(23.90±2.02)分比(26.95±2.01)分]均有下降,血清 NfL[( 44.48±6.07)ng/L、(71.40±14.59)ng/L、(131.82±45.24)ng/L比( 30.05±10.93)ng/L]、 Tau蛋白[(46.76±8.06)ng/L、(68.39±15.94)ng/L、(175.35±52.69)ng/L比( 29.65±6.65)ng/L]明显升高( P<0.05)。中重度病人行 CPAP治疗 3月后, MoCA、MMSE评分较前提高,血清 NfL、Tau蛋白较前下降( P<0.05)。结论 OSA病人常合并认知损害, OSA病情越重,认知损害越重,血清 NfL、Tau蛋白水平越高。 CPAP治疗可以改善 OSA病人认知功能,降低血清 NfL、Tau蛋白水平。
英文摘要:
      Objective To analyze the cognition of patients with obstructive sleep apnea (OSA) and to study the effect of continuouspositive airway pressure (CPAP) on cognition and serum neurofilament light chain (NfL) and Tau protein in patients with OSA.Meth. ods Ninety OSA patients admitted to the respiratory sleep monitoring center of the Affiliated Hospital of Xuzhou Medical Universityfrom March 2022 to May 2023 were selected, and were assigned into 26 cases in the mild group (5-15 times/h), 31 cases in the moder-ate group (>15-30 times/h), and 33 cases in the severe group (>30 times/h) according to the apnea hypopnea index (AHI), and 30 casesin the healthy medical checkups of the same period of time at the Affiliated Hospital of Xuzhou Medical University were selected as thecontrol group. The MoCA and MMSE were used to assess cognitive function, and ELISA was used to detect serum NfL and Tau proteinlevels. Moderate and severe patients were given CPAP treatment for 3 months, and the changes in the cognition of the patients withOSA and the changes in the serum NfL and Tau protein before and after the treatment were compared.Results Compared with the con-trol group, MoCA [(24.65±3.13) points, (23.69±4.34) points, (21.94±3.26) points vs. (27.20±1.29) points] and MMSE scores [(25.23± 3.43) points, (24.53±2.14) points, (23.90±2.02) points vs. (26.95±2.01) points] decreased and serum NfL [(44.48±6.07) ng/L, (71.40± 14.59) ng/L, (131.82±45.24) ng/Lvs. (30.05±10.93) ng/L] and Tau protein [(46.76±8.06) ng/L, (68.39±15.94) ng/L, (175.35±52.69) ng/L vs. (29.65±6.65) ng/L] significantly increased in the OSA group (P<0.05). After 3 months of CPAP treatment in moderate-to-severe pa-tients, MoCA and MMSE scores were improved and serum NfL and Tau protein were decreased compared with before (P<0.05).Conclu. sions OSA patients are often combined with cognitive impairment, and the more severe the OSA condition, the more cognitive impair-ment, and the higher the serum NfL and Tau protein levels. CPAP treatment can improve the cognitive function of OSA patients and re-duce the serum NfL and Tau protein levels.
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