【摘要】 目的 探讨呼气正压鼻塞治疗对阻塞型睡眠呼吸暂停低通气综合征（OSAHS）患者认知功能的影响及其抗氧化作用机制。方法 选取OSAHS患者62例（OSAHS组）和健康体检者60例（NC组）,比较其认知功能和抗氧化相关指标。将OSAHS组患者随机分为持续正压通气（CPAP）组31例和鼻塞组31例,分别于治疗前及治疗7天、14天及21天时监测其睡眠呼吸情况、评估认知功能、检测抗氧化相关指标并进行比较。结果 治疗前OSAHS组患者延迟记忆、计算力、词语流畅性评分、MoCA评分总分及SOD浓度均低于NC组,MDA浓度明显高于NC组（P<0.01）。CPAP组和鼻塞组患者治疗7天、14天、21天时,最低动脉血氧饱和度（SaO₂）和平均SaO₂均逐渐升高,呼吸暂停低通气指数（AHI）均逐渐下降,与治疗前比较差异有统计学意义（P<0.01或P<0.05）。治疗后CPAP组和鼻塞组患者认知功能各项评分及总分均逐渐升高。治疗21天时CPAP组和鼻塞组患者延迟记忆、计算力及词语流畅性评分及MoCA评分总分均高于同组治疗前（P<0.05或P<0.01）。CPAP组和鼻塞组患者治疗14天时和21天时SOD浓度均高于同组治疗前,MDA浓度均低于同组治疗前（P<0.01）。结论 呼气正压鼻塞对OSAHS及其引起的认知功能障碍具有一定治疗作用,可能是通过改善氧化应激状态、调节氧化-抗氧化平衡来实现。更多还原

【Abstract】 Objective To explore the effects of expiratory positive nasal congestion therapy on cognitive function in patients with OSAHS and its anti-oxidation mechanism. Methods Sixty-two patients with OSAHS were selected as OSAHS group,60 healthy controls as NC group and compare their ognitive function and indexes of anti-oxidation. Patients in OSAHS group were randomly divided into CPAP group and nasal congestion group with 31 cases in each group. The sleep and respiration status were monitored,cognitive function was evaluated and indexes of anti-oxidation were detected respectively in patients of CPAP group and nasal congestion group before treatment and at the 7 th, 14 th and 21 st day after treatment.Results Delay memory,computational ability,verbal fluency score,total MoCA scores and SOD concentration before treatment in OSAHS group were lower than those in NC group,while MDA concentration was obviously higher than that in NC group(P < 0. 01). Lowest Sa02, average Sa02 increased gradually and AHI decreased gradually at the 7 th, 14 th and 21 st day after treatment in CPAP group and nasal obstruction group, and compared with those before treatment, the differences were significant( P < 0. 05 or P < 0. 01).Each item scores and total score of cognitive function in CPAP group and nasal congestion group increased gradually after treatment. Delayed memory, computational ability, verbal fluency score and total MoCA score were higher 21 days after therapy than those in the same group before treatment in CPAP group and nasal obstruction group(P<0.05 or P <0.01). SOD concentrations 14 days and 21 days after treatment in CPAP group and nasal obstruction group were higher than those in the same group before treatment, and MDA concentrations were lower than those in the same group before treatment( P < 0. 01). Conclusion Expiratory positive nasal congestion has therapeutic effect on OSAHS and its cognitive dysfunction, which may be achieved by improving status of oxidative stress and regulating oxidation-anti-oxidant balance.更多还原