【摘要】 目的 明确阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea,OSA）的严重程度对缺血性脑卒中后认知功能障碍的影响，并探讨其可能机制。方法 选取2018-12—2020-12于福建省立医院神经内科及康复科住院的缺血性脑卒中并伴OSA患者为研究对象，纳入196例患者，收集患者临床资料，并进行睡眠呼吸监测，根据AHI将患者分为轻度OSA组及中重度OSA组，并对所有患者在入院后3周及入院后6个月进行认知功能评估。结果 入院3周后轻度OSA组MoCA总分高于中重度OSA组，在视空间与执行能力、命名、注意力、定向力中，轻度OSA组得分均优于中重度OSA组[MoCA总分：（22.15±1.98）分vs(20.0±2.01)分，P<0.05；视空间与执行能力：（3.14±0.29）分vs(2.03±0.18)分，P<0.05；命名：（3.25±0.31）分vs(2.87±0.27)分，P<0.05；注意力：（4.51±0.52）分vs(4.03±0.48)分，P<0.05；定向力：（5.67±0.62）分vs(5.02±0.49)分，P<0.05]。患病后6个月，轻度OSA组MoCA总得分仍明显优于中重度组，同时在视空间与执行能力、命名、注意力、延迟回忆及定向力得分优于中重度OSA组[MoCA总分：（22.65±2.17）分vs(20.0±1.99)分，P<0.05；视空间与执行能力：（3.34±0.32）分vs(2.24±0.14)分，P<0.05；命名：（3.68±0.27）分vs(2.93±0.29)分，P<0.05；注意力：（4.65±0.54）分vs(4.25±0.47)分，P<0.05；延迟回忆：（3.59±0.28）分vs(2.72±0.28),P<0.05；定向力：（5.71±0.71）分vs(5.13±0.51)分，P<0.05]。结论 OSA的严重程度与缺血性脑卒中后认知功能障碍呈正相关，主要表现在视空间与执行能力、命名、注意力、延迟回忆及定向力方面。更多还原

【Abstract】 Objective To determine the effect of the severity of obstructive sleep apnea(OSA)on cognitive dysfunction after ischemic stroke,and to explore its possible mechanism.Methods stroke and OSA who were hospitalized in the Department of Neurology and Rehabilitation of Fujian Provincial Hospital from December 2018 to December 2020 were selected as the research objects. A total of 196 patients were included in this study. The clinical data of the patients were collected,and sleep breathing was monitored. According to AHI,the patients were divided into mild OSA group and moderate-severe OSA group. All patients were evaluated for cognitive function 3 weeks after admission and 6 months after admission.Results Three weeks after admission,the total MoCA score of the mild OSA group was higher than that of the moderate to severe OSA group. At the same time,the scores of mild OSA group were better than those in the moderate-to-severe OSA group in terms of visual space and executive ability,naming,attention,and orientation(mild OSA vs moderately severe OSA:MoCA total score:22.15±1.98 vs 20.0±2.01,P<0.05;visual space and executive ability:3.14±0.29 vs2.03±0.18,P<0.05;nomenclature:3.25± 0.31 vs 2.87±0.27,P<0.05;attention:4.51±0.52 vs 4.03±0.48,P<0.05;orientation:5.67±0.62 vs 5.02±0.49,P<0.05). At 6 months after the illness,the total MoCA score of the mild OSA group was still significantly better than that of the moderate to severe group. At the same time,in visual space and executive ability,naming,attention,delayed recall and orientation,the scores of mild OSA group were better than those in the moderate to severe OSA group(mild OSA vs moderately severe OSA:MoCA total score:22.65±2.17vs 20.0±1.99,P<0.05;visual space and executive ability:3.34±0.32 vs 2.24±0.14,P<0.05;nomenclature:3.68±0.27 vs 2.93±0.29,P<0.05;attention:4.65±0.54 vs 4.25±0.47,P<0.05;delayed recall:3.59±0.28 vs 2.72±0.28,P<0.05;orientation:5.71 ± 0.71 vs 5.13 ± 0.51,P<0.05).Conclusion with cognitive dysfunction after ischemic stroke,mainly in terms of visual space and executive ability,naming,attention,delayed recall and orientation.更多还原