The Study On The Association Of Cognitive Impairment In Cerebral Microbleeds With OSAHS And Serum P-Tau

Objective:To study the relationship between OSAHS and cerebral microbleeds,and the correlation between the severity of OSAHS and the severity of cerebral microbleeds,to explore the relationship between serum P-Tau and cognitive impairment in cerebral Microbleeds with OSAHS.Methods:All cases were from the department of Neurology,the Second Hospital of Kunming Medical University.70 inpatients were collected from March 2017 to January 2018.there are 40 patients with cerebral microbleeds(including 28 with OSAHS and 12 without OSAHS)and 30 patients without cerebral microbleeds(including 9 cases with OSAHS and 21 cases without OSAHS).The general information of selected subjects and the risk factors related to cerebrovascular disease(including age,gender,body mass index,history of hypertension.diabetes.hyper-lipidemia,heart disease,smoking history,drinking history,and education level)were recorded.All patients were required to perform blood lipid,uric acid,serum homocysteine levels,polysomnography,and cranial magnetic resonance imaging(including T1WI,T2WI.DWI,and SWI).For the 40 patients with cerebral microbleeds,5 ml fasting venous blood should be collected to quantitatively detect serum P-Tau protein levels,and the MoCA and Wechsler scales(4 subtests for picture recall,visual regeneration,memory understanding,and digital breadth test)should be required to complete.SPSS 17.0 statistical software was used for data analysis,in which measurement data were expressed as mean±standard deviation(x ±s),and normality test was performed.Comparison between groups was performed using two independent samples t-test;the count data were analyzed using a completely randomized four-grid chi-square test(X2 test);single-factor correlation analysis was performed using Spearman correlation analysis,Logistic regression analysis was used for risk factor analysis,the threshold for variable selection and rejection was 0.05,P<0.05 was considered statistically significant.Results:In the study of the relationship between OSAHS and CMBs,the BMI of CMBs group was higher than that of non-CMBs group,the difference between the two groups was statistically significant(P<0.05).The TG level in CMBs group was higher than In the non-CMBs group,the HDL level was lower than that in the non-CMBs group,there was a statistically significant difference between the two groups(P<0.05).The proportion of hypertension in the CMBs group was higher than the non-CMBs group,the difference was statistically significant(P<0.05).The proportion of OSAHS patients in CMBs group was significantly higher than that in non-CMBs group(P<0.05),and the AHI mean value in CMBs group was significantly higher than that in non-CMBs group(P<0.05),the differences were statistically significant,and there was a positive correlation between the number of microbleeding lesions and the AHI value(rs=0.434,P<0.05).Statistical analysis of possible risk factors by two-class Logistic regression analysis showed that hypertension(X2=3.827,P=0.050)and OSAHS(X2=8.966,P=0.003)were independent risk factors for cerebral microbleeds.The risk of cerebral microbleeds was 3.228 times that of non-hypertensive patients.The risk of cerebral microbleeds in OSAHS patients was 5.087 times that of non-OSAHS patients.In the study of the relationship between serum P-tau protein,OSAHS and cerebral microbleeds cognitive dysfunction,the mean score of MoCA scale in CMBs with OSAHS group was significantly lower than that in CMBs without OSAHS group,and the difference between the two groups was statistically significant(P<0.05).The proportion of cognitive impairment in CMBs with OSAHS group was higher than that in CMBs without OSAHS group(P<0.05).The scores of Wechsler scale comprehension memory and digit breadth in CMBs with OSAHS group were lower than those of the CMBs without OSAHS group,the difference between the two groups was statistically significant(P<0.05).The mean score of the MoCA scale in mild CMBs group was higher than that in the medium-severe CMBs group,the difference between the two groups was statistically significant(P<0.05).In the visual regeneration,comprehension memory,and digital breadth subtests,the scores of mild CMBs group was also higher than that of moderate-heavy degree,the difference was statistically significant(P<0.05).The serum P-Tau protein concentration in CMBs with OSAHS group was higher than that in CMBs without OSAHS group.The difference was statistically significant(P<0.05).Conclusions:1.OSAHS is a risk factor for cerebral microbleeds,and the severity of cerebral microbleeds is positively correlated with the severity of OSAHS;2.OSAHS is an important risk factor for cognitive impairment of CMBs,and the degree of cognitive impairment of CMBs is positively correlated with the severity of CMBs;3.OSAHS may affect the cognitive impairment in cerebral microbleeds by upgrading concentration of P-Tau protein.