阻塞性睡眠呼吸暂停加重卒中后认知功能障碍及血清BDNF与Tau蛋白的诊断价值

doi:10.16352/j.issn.1001-6325.2025.09.1195

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (9): 1195-1199.doi: 10.16352/j.issn.1001-6325.2025.09.1195

阻塞性睡眠呼吸暂停加重卒中后认知功能障碍及血清BDNF与Tau蛋白的诊断价值

赵东梅, 曹飞虎, 王丽波, 黄骏, 杜雨欣, 刘倩^*

绵阳市第三人民医院(四川省精神卫生中心) 神经内科,四川绵阳 621000

收稿日期:2025-05-09 修回日期:2025-06-23 发布日期:2025-08-27
通讯作者: ^*zzhaomei8333@163.com
基金资助:
四川省卫生计生委科研项目(140037)

Obstructive sleep apnea exacerbates cognitive impairment after stroke and the diagnostic value of serum BDNF and Tau protein

ZHAO Dongmei, CAO Feihu, WANG Libo, HUANG Jun, DU Yuxin, LIU Qian^*

Department of Neurology, the Third People′s Hospital of Mianyang City(Sichuan Provincial Mental Health Center), Mianyang 621000, China

Received:2025-05-09 Revised:2025-06-23 Published:2025-08-27
Contact: ^*zzhaomei8333@163.com

摘要/Abstract

摘要： 目的探讨阻塞性睡眠呼吸暂停(OSA)对卒中后患者认知功能障碍的影响,并通过动态监测血清中中脑源性神经营养因子(BDNF)与Tau蛋白的水平变化,揭示其潜在机制及诊断价值。方法选取2022年2月至2024年6月绵阳市第三人民医院收治的98例卒中患者,依据是否伴有OSA分为两组,在卒中后1周、1、3和6个月运用神经心理学量表评估认知功能,ELISA检测血清BDNF与Tau蛋白水平,并分析其与认知功能障碍程度的相关性及诊断价值。结果 OSA组呼吸暂停-呼吸浅慢活动度指数(AHI)显著高于non-OSA组,LSaO₂和MSaO₂显著低于non-OSA组(P＜0.05)。发病后1周、1、3和6个月,OSA组MMSE和MoCA评分均显著低于non-OSA组(P＜0.05);OSA组BDNF水平低于non-OSA组,Tau蛋白水平高于non-OSA组(P＜0.05)。Pearson相关分析结果显示,血清BDNF水平与MMSE评分(r=0.654,P＜0.001)和MoCA评分(r=0.689,P＜0.001)均呈显著正相关,即血清BDNF水平越高。而血清Tau蛋白水平与MMSE评分(r=-0.623,P＜0.001)和MoCA评分(r=-0.667,P＜0.001)均呈显著负相关。BDNF、Tau蛋白两项指标联合检测的曲线下面积(AUC)大于单独检测的AUC,两者联合检测对卒中后患者认知功能障碍的诊断价值大于单独检测(P＜0.05)。结论 OSA显著加剧了卒中后的认知功能障碍,而血清BDNF水平升高和Tau蛋白水平下降可能是认知功能障碍重要相关相关机制之一,在卒中后认知功能障碍的诊断中具有较高的应用价值。

关键词: 阻塞性睡眠呼吸暂停, 卒中, 认知功能障碍, 脑源性神经营养因子, Tau蛋白

Abstract: Objective To explore the impact of obstructive sleep apnea (OSA) on cognitive impairment in post-stroke patients ,to explore its underlying mechanism and to evaluate potential diagnostic value by dynamically monitoring the level of brain-derived neurotrophic factor (BDNF) and Tau protein in serum. Methods Totally 96 stroke patients admitted to Mianyang third People's Hospital from February 2022 to June 2024 were selected. They were divided into the groups complicated with OSA and control one without OSA following up of neuropsychological scales for 1 week, 1 month, 3 months, and 6 months after stroke for evaluating cognitive function. Enzyme-linked immunosorbent assay (ELISA) was applied to detect the level of BDNF and Tau protein in serum. The correlation of test results and the degree of cognitive impairment as well as their diagnostic value were analyzed. Results The AHI in the OSA group was significantly higher than that of control group, while LSaO₂ and MSaO₂ were significantly lower in the OSA group (P＜0.05). One week and 1,3,6 month months after the onset of the disease, the MMSE and MoCA scores in the OSA group were significantly lower than those in the control group, BDNF level was significantly lower while Tau protein level was significantly higher as compare to those in control group (P＜0.05). Pearson correlation analysis showed that the serum BDNF level was positively correlated with both MMSE score (r=0.654, P＜0.001) and MoCA score (r=0.689, P＜0.001).However, the serum Tau protein level was negatively correlated with both MMSE score (r=-0.623, P＜0.001) and MoCA score (r=-0.667, P＜0.001). The area under the curve (AUC) of the combined detection of BDNF and Tau protein was greater than that of the individual detection. The diagnostic value of the combined detection of BDNF and Tau protein for cognitive impairment in post-stroke patients was greater than that of the individual detection (P＜0.05). Conclusions OSA significantly exacerbates patients’ cognitive impairment after stroke. Elevated serum BDNF level and decreased Tau protein level may be the underlying mechanisms of cognitive impairment. Serum BDNF and Tau protein may function as potential biomarkers for diagnosis of cognitive impairment after stroke.

Key words: obstructive sleep apnea, stroke, cognitive impairment, brain-derived neurotrophic factor, Tau protein

中图分类号:

R742

赵东梅, 曹飞虎, 王丽波, 黄骏, 杜雨欣, 刘倩. 阻塞性睡眠呼吸暂停加重卒中后认知功能障碍及血清BDNF与Tau蛋白的诊断价值[J]. 基础医学与临床, 2025, 45(9): 1195-1199.

ZHAO Dongmei, CAO Feihu, WANG Libo, HUANG Jun, DU Yuxin, LIU Qian. Obstructive sleep apnea exacerbates cognitive impairment after stroke and the diagnostic value of serum BDNF and Tau protein[J]. Basic & Clinical Medicine, 2025, 45(9): 1195-1199.

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阻塞性睡眠呼吸暂停加重卒中后认知功能障碍及血清BDNF与Tau蛋白的诊断价值

Obstructive sleep apnea exacerbates cognitive impairment after stroke and the diagnostic value of serum BDNF and Tau protein

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