【摘要】

目的:观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者认知功能及血清硫氧还蛋白(TRX)水平的变化，并分析其相关性。
方法:共收集67例（男49例，女18例）OSAHS患者和20例（男14，女6例）健康志愿者作对照组，分别进行多导睡眠图(PSG)监测，应用爱泼沃斯思睡量表(ESS)、简易智能状态量表(MMSE)、画钟试验(CDT)评估患者白天嗜睡程度及认知功能，并检测血清氧化应激指标硫氧还蛋白(TRX)、超氧化物歧化酶（SOD）和丙二醛（MDA）的水平。同时收集OSAHS患者经CPAP治疗者15例（男11例，女4例），作为CPAP治疗组，观察上述指标治疗前后的变化。
结果：（1）与健康对照组比较，OSAHS组及CPAP治疗组的MMSE、CDT评分降低。与重度OSAHS组（PSG
结果AHI≥40次/小时者，下同）比较，CPAP治疗组MMSE、CDT评分升高。（2）与健康对照组比较，OSAHS组及CPAP治疗组的血清TRX、MDA水平升高，而SOD水平降低。与重度OSAHS组比较，CPAP治疗组血清TRX、MDA水平降低，SOD水平升高。（3）所有受试者血清TRX、MDA、SOD水平与PSG相关指标（最低SaO2、AHI、LA(H)T、SLT90%）均分别相关，且有统计学意义。（4）所有受试者血清TRX、MDA、SOD水平与MMSE、CDT评分均分别相关。（5）所有受试者血清TRX水平与MDA、SOD相关，且均有统计学意义。
结论：OSAHS患者认知功能障碍与病情的严重程度有关，且主要表现为短时记忆能力和计算能力等方面受损；TRX是反映OSAHS患者体内氧化还原状态、氧化应激的早期敏感指标，且与其认知功能障碍密切相关。

【Abstract】

Objective To observe the change of the cognitive function and the serum level of thioredoxin (TRX) of patients with obstructive sleep apnea hypopnea syndrome(OSAHS). And then, to investigate the correlation. Method 67 patients with OSAHS, 20 healthy controls with matched age, BMI, and education, 15 patients with OSAHS after effective treatment of continuous positive airway pressure (CPAP) with matched age, BMI, and education were list. Polysomnography(PSG), Epworth sleepiness scale(ESS), mini-mental state examination(MMSE), clock drawing test(CDT) were detected in these groups．The serum level of TRX, Superoxide Dismutase (SOD), Malondialdehyde(MDA) were measured. Result (1) The MMSE, CDT scores of OSAHS were decreased compared to those in healthy controls; these scores elevated after effective CPAP treatment. (2)The serum TRX and MDA of OSAHS were increased compared to those in healthy controls; these concentrations decreased after effective CPAP treatment; and the serum SOD of OSAHS were decreased compared to those in healthy controls; these concentrations increased after effective CPAP treatment. (3) The serum TRX, MDA, SOD of all the subjects were correlative with the results of PSG(lowest SaO2, AHI, LA(H)T, SLT90%), respectively.(4) The serum TRX, MDA, SOD of all the subjects were correlative with the MMSE, CDT scores, severally.(5) The serum TRX of all the subjects were correlative with the serum MDA, SOD.
Conclusion   Cognitive impairment of patients with OSAHS is correlative with the severity of this disease; TRX is a useful index reflecting redox state and oxidative stress in patients with OSAHS, and is close correlative with the cognitive impairment of patients with OSAHS.