MCP-1 And SAA Levels In Patients With COPD-OSAHS Overlap Syndrome And Their Effect On Cognitive Function

Objectives This experiment was to study the cognitive function and the level of monocyte chemotactic protein 1,serum amyloid A protein(SAA) in patients with COPD-OSAHS overlap syndrome(OS) and to explore the relationship between the cognitive function and MCP-1, SAA and the other clinical factors.Methods 1 subject The study collected from the hospitalized patients of Tangshan Pacific Alliance Medical Center and North Chian university of science and technology Department of respiration. The patients were divived into 40 patients with overlap syndrome, 40 cases with chronic obstructive pulmonary disease(COPD) alone and simple OSAHS patients with 40 cases through the pulmonary function, polysomnography and history of diagnosis. 2 methods Detecte clinical indicators, such as BMI, age,smoking, education. Finish the test of pulmonary function, arterial blood gas analysis,and polysomnography. Mo CA scale was used to evaluate cognitive function. Measured serum level of MCP-1 and SAA by using ELISA and Q-PCR, the data above was analysed by SPSS 19.0.Results 1 Comparison of the age, gender, BMI, smoking, education, patients with OS groups, COPD group and OSAHS group were not statistically significant(P>0.05).2 The level of MCP-1 and SAA in OS group was significantly higher than COPD and OSAHS by ELISA, the difference was statistically significant(P<0.01). 3 Compared with the m RNA levels of MCP-1and SAA between OS group and the other two groups by Q-PCR, the OS group was statistically significant higher.(P<0.01). 4 Scores of Mo CA in the OS group were significantly lower than those in the COPD and OSAHS group, and the different sub items such as the visual spatial executive ability, naming,language et al were all lower than the other two groups, the difference were statistically significant(P<0.05). 5 Score of Mo CA was negatively correlated with age, smoking,Pa CO2、AHI(r=-0.417~-0.613,P<0.05), and positively correlated with education,PO2, Sa O2, La SO2, FEV1% and FEV1/FVC(r=0.440~0.691, P < 0.01). 6 The levels of MCP-1 and SAA was significantly negatively related to the score of Mo CA( r=-0.659,-0.630 respectively, P < 0.01). 7 Multiple factors regression analysis showed that: MCP-1、SAA、smoking、age、LSa O2、education、AHI had predictive power on recognitive function. "MCP-1"(β=-0.134,t=-2.045,P<0.05)、 "SAA"( β=-0.189, t=-3.022, P < 0.05) had the negative prediction effects on cognitive function, the "age", "smoking", "AHI" had negative prediction effects, meanwhile the "education", " LSa O2" had positive prediction. 8 The AUC of the ROC curve of MCP-1and SAA were 0.850 and 0.827, respectively.Conclusions 1 The levels of MCP-1 and SAA were significantly increased in patients with overlap syndrome. 2 Compared with COPD group and OSAHS group, there were more severe cognitive dysfunction in patients with overlap syndrome. With the increase of MCP-1 and SAA leverls the cognitive fucnction of OS patients was significantly decreased. 3 Hypoxia, sleep fragmentation and smoking had effect on cognitive function.