The Influence Of OSAS For Stroke And Cognitive Functions

[Objective]Registration the general situation of patients with acute cerebral ischemic stroke and obstructive sleep apnea syndrome to assessment the cognitive function by Mini-Mental State Examination (Mini-Mental State Examination, MMSE), Montreal Cognitive Assessment (Montreal cognitive assessment, MoCA) Scale, Wechsler memory Scale (Wechsler Memory Scale, WMS) and hippocampus linear measurement, to explore the obstructive sleep apnea syndrome (OSAS) effects on cognitive function in patients with acute cerebral stroke and cognitive features of damage and pathogenesis.[Methods]All cases were from the department of Neurology,The Second Affiliated Hospital of Kunming Medical University, collected40cases of hospitalized patients from November2012to November201320patients with acute ischemic stroke without OSAS, and20patients with ischemic stroke group merger of OSAS. To record the general condition of all patients, including gender, age, height, weight, body mass index, lipid levels, years of education, medical history, hypertension and diabetes, National Institutes of Health Stroke Scale(National Institutes of Health Stroke Scale, NIHSS) in all patients, and record the score. All patients were administered polysomnography (PSG) examination, and recorded apnea index (apnea hypopnea index, AHI), lowest arterial oxygen saturation (minimal arterial oxygen saturation, SaO2min). All selected patients analyzed by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (Montreal cognitive assessment, MoCA) Scale, the Wechsler Memory Scale (Wechsler Memory Scale, WMS),which scores were assessed for cognitive function.All selected patients performed conventional cranial MRI T1-weighted imaging, T2-weighted imaging, fluid-attenuated inversion recovery sequence (FLAIR) and diffusion-weighted imaging (DWI) and TLC scanning hippocampus, temporal lobe performed hook back spacing, the longitudinal axis of the hippocampus length measurement. Application SPSS17.0statistical software analysis and comparison of the two groups and the total score of cognitive function scores in all areas of cognitive differences, differences in hippocampus linear correlation analysis conducted measurements.[Results]40patients have had completed all the checks. By PSG findings apnea-hypopnea index (AHI) into OSAS group (20), non-OSAS group (20). OSAS group BMI higher than non-OSAS group, and the difference was statistically significant. OSAS group MMSE, MOCA, MQ score lower than non-OSAS group, the two groups MMSE, MOCA, MQ difference was not statistically significant. OSAS group orientation, immediate memory, computing power, memory latency are lower than non-OSAS group, OSAS group was significantly lower than non-OSAS memory latency group, two groups of orientation, immediate memory, computing power, memory latency. Difference is not statistically significant. OSAS group cognitive impairment MMSE scores lower than non-OSAS group. Two cognitive impairment MMSE score differences was not statistically significant. The two groups of patients had cognitive impairment, OSAS group MOCA cognitive function score lower than the non-OSAS group, the two groups MOCA cognitive function score difference was not statistically significant. OSAS group cognitive impairment MOCA scores than non OSAS group. MOCA score cognitive impairment groups showed no significant difference. Moderate to severe OSAS group MMSE, MOCA, MQ scores considerably lower than the mild OSAS group and the non-OSAS group. MMSE score difference between the three groups was significant (p<0.05):pairwise comparisons:non-OSAS group with mild OSAS group difference was not statistically significant (p>0.05), non-OSAS group, mild and moderate to severe OSAS group OSAS group, the difference was significant (p<0.05). Three groups MOCA score difference was statistically significant (p<0.05); pairwise comparisons:moderate to severe OSAS group, mild OSAS group and non-OSAS group, the difference was significant (p<0.05), moderate to severe OSAS group and the light severe OSAS group had no significant difference (p>0.05). MQ score difference between the three groups was significant (p<0.05); pairwise comparison: mild OSAS group, moderate and severe OSAS group and non-OSAS group, the difference was significant (p<0.05), and in the group with mild OSAS severe OSAS group difference was not statistically significant. Two groups OSAS groups standardized temporal lobe uncus wide spacing than non-OSAS group, and the difference was statistically significant. OSAS group between the two groups on the left and right hippocampus vertical axis length is shorter than the non-standardized OSAS group, and the difference was statistically significant(p<0.05). Moderate to severe OSAS group standardized temporal lobe hook back spacing greater than mild OSAS combination of non-OSAS group, and the difference was statistically significant (p <0.05). Moderate to severe OSAS group is less than the length of the longitudinal axis of bilateral hippocampus mild OSAS group and the non-OSAS group, and the difference was statistically significant (p<0.05). Measurement and AHI hippocampus correlation analysis showed that standardized temporal lobe hook back spacing, standardization hippocampus vertical axis (left), standardization hippocampus vertical axis (right) were associated with AHI (P<0.05).[Conclusions]OSAS can increase the cognitive dysfunction in patients with stroke, and increase the severity of OSAS exacerbated. OSAS may exacerbate hippocampus atrophy in patients with stroke, and increase the severity of OSAS exacerbated.