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Eur Respir J:阻塞性睡眠呼吸暂停中老年人轻度认知功能障碍

2018-11-04 xing.T MedSci原创

由此可见,迷你精神状态检查不应用于筛查阻塞性睡眠呼吸暂停患者的认知障碍。蒙特利尔认知评估可用于临床。然而,当怀疑患者存在神经退行性过程时,临床医生应该转诊患者进行神经心理学评估。

阻塞性睡眠呼吸暂停会增加轻度认知障碍和痴呆的风险。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,该研究旨在归纳两种认知筛查工具,即迷你精神状态评估和蒙特利尔认知评估,评估患有和不患有阻塞性睡眠呼吸暂停的55-85岁成人轻度认知障碍的能力。

研究人员共纳入了42名患有轻度和67名中度至重度阻塞性睡眠呼吸暂停的受试者。研究人员将这些受试者与22名对照者进行了比较。通过全面的神经心理学评估诊断出轻度认知障碍。研究人员使用受试者操作特征曲线来评估两种筛查工具检测轻度认知障碍的能力。

研究人员发现两项筛查工具在对照者中具有相似的辨别能力。然而,在轻度和中度至重度阻塞性睡眠呼吸暂停患者中,迷你精神状态评估未能正确识别具有轻度认知障碍的受试者。蒙特利尔认知评估的辨别能力在两个睡眠呼吸暂停组中均可接受,并且在对照者中也观察到的相当效果。

由此可见,迷你精神状态检查不应用于筛查阻塞性睡眠呼吸暂停患者的认知障碍。蒙特利尔认知评估可用于临床。然而,当怀疑患者存在神经退行性过程时,临床医生应该转诊患者进行神经心理学评估。

原始出处:


Katia Gagnon,et al.Detection of mild cognitive impairment in middle-aged and older adults with obstructive sleep apnoea.Eur Respir J.2018.http://erj.ersjournals.com/content/52/5/1801137

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  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351548, encodeId=7caf35154832, content=学习一下,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/nmoH3FVKe8KYYzm5OrpnZastaKg0jKDyvlVBp8RUZUBgynaVPQ86l6DbaqohIM3eIsowIy6V53q5n5mYuyzD6w/132, createdBy=aac72353870, createdName=122b87b4m49(暂无昵称), createdTime=Sun Nov 04 21:05:34 CST 2018, time=2018-11-04, status=1, ipAttribution=)]
    2019-03-11 12167ae9m50暂无昵称

    学习一下

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351548, encodeId=7caf35154832, content=学习一下,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/nmoH3FVKe8KYYzm5OrpnZastaKg0jKDyvlVBp8RUZUBgynaVPQ86l6DbaqohIM3eIsowIy6V53q5n5mYuyzD6w/132, createdBy=aac72353870, createdName=122b87b4m49(暂无昵称), createdTime=Sun Nov 04 21:05:34 CST 2018, time=2018-11-04, status=1, ipAttribution=)]
    2019-10-08 tomyang96
  7. 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  8. 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  9. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351548, encodeId=7caf35154832, content=学习一下,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/nmoH3FVKe8KYYzm5OrpnZastaKg0jKDyvlVBp8RUZUBgynaVPQ86l6DbaqohIM3eIsowIy6V53q5n5mYuyzD6w/132, createdBy=aac72353870, createdName=122b87b4m49(暂无昵称), createdTime=Sun Nov 04 21:05:34 CST 2018, time=2018-11-04, status=1, ipAttribution=)]
    2018-11-04 观宇

    挺好

    0

  10. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351548, encodeId=7caf35154832, content=学习一下,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/nmoH3FVKe8KYYzm5OrpnZastaKg0jKDyvlVBp8RUZUBgynaVPQ86l6DbaqohIM3eIsowIy6V53q5n5mYuyzD6w/132, createdBy=aac72353870, createdName=122b87b4m49(暂无昵称), createdTime=Sun Nov 04 21:05:34 CST 2018, time=2018-11-04, status=1, ipAttribution=)]
    2018-11-04 122b87b4m49(暂无昵称)

    学习一下,谢谢

    0

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鉴于该样本在预防痴呆方面的临床意义,灰质的这些变化揭示了OSA如何促成老年人神经退行性的过程。

Respirology:OSA的严重程度与血脂水平相关

8月21日,在线发表于《Respirology》杂志上的一项研究显示,阻塞性睡眠呼吸暂停(OSA)的严重程度与胆固醇和甘油三酯水平独立相关。

Am J Resp Crit Care:吸氧对阻塞性睡眠呼吸暂停患者血压的影响

由此可见,补充氧气实际上消除了停止CPAP期间早晨BP的升高。吸入氧气基本上减少了间歇性缺氧,但对唤醒的标志(包括AHI)、主观或客观嗜睡的影响极小。因此,间歇性缺氧而非复发性唤醒似乎是OSA患者BP日间升高的主要原因。

Eur Respir J:佐匹克隆治疗1个月对阻塞性睡眠呼吸暂停严重程度和症状的影响

由此可见,在没有严重的夜间低氧血症的情况下,1个月的佐匹克隆治疗不会恶化OSA的严重程度、嗜睡或警觉性。作为首次评估安眠药对OSA严重程度和嗜睡影响的研究,这些研究结果提供了重要的安全性数据和对OSA病理生理学的深入了解。

2018 ATS临床实践指南:体重管理在治疗成人阻塞性睡眠呼吸暂停中的作用

2018年9月,美国胸科学会(ATS)发布了关于体重管理在治疗成人阻塞性睡眠呼吸暂停中的作用的临床指南,超重/肥胖是常见的可逆性的阻塞性睡眠呼吸暂停(OSA)的危险因素,本文的主要目的是针对超重/肥胖患者OSA的管理提出指导建议。

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