NGAL And ET-1 Levels In Patients With Copdosahs Overlap Syndrome And Their Effect On Cognitive Function

Objectives This experiment was to explore the expression of neutrophil gelatinaseassociated lipocalin（NGAL）and endothelin-1（ET-1）in serum of patients with COPDOSAHS overlap syndrome（OS）,as well as the relationship between NGAL、ET-1 and cognitive function.Methods The patients for study were collected from the hospitalized patients in respiration department of North China university of science and technology.Cognitive function of patients was evaluated by Mo CA,ang history-taking,blood gas analysis,pulmonary function tests,and polysomnography were displayed for patients,respectively.The patients were divived into three groups,35 patients with overlap syndrome,27 cases with pure COPD,and 35 patients with pure OSAHS,and all of them with cognitive impairment.Then general situation questionnaire was formed based on related literatures.The clinical indicators were gathered,such as smoking,age,BMI,education and so on.Serum level of NGAL and ET-1 were measured by ELISA,respectively.The data above was analysed by SPSS 17.0.Results 1 There were not statistical differences in the gender,age,BMI,education,and smoking among the patients with OS group,the pure COPD group and the pure OSAHS group（P>0.05）.2 There were statistical differences（P<0.05）in PH、Pa O₂ and Pa CO₂ among the three groups.Compared with the pure OSAHS group,the OS group was higher in PH and Pa CO₂,while lower in Pa O₂,and the differences were statistically significant（P <0.05）.While there were not statistical differences between the OS group and the pure COPD group in PH,Pa O₂,and Pa CO₂（P>0.05）.3 There were statistical differences（P<0.05）in FEV1/FVC and FEV1%pred among the three groups.The OS group was lower than the pure OSAHS group in FEV1/FVC and FEV1%pred（P <0.05）,while there were not statistical differences between the OS group and the pure COPD group（P>0.05）.4 There were statistical differences（P <0.05）in AHI and LSa O₂ among the three groups.Compared with the other two groups,the OS group was higher in AHI（P<0.05）,while lower in LSa O₂（P<0.05）.5 Compared with the other two groups,the OS group was higher in the levels of NGAL and ET-1,and the differences were statistically significant（P<0.05）.6 There were statistical differences in the visual spatial executive ability,naming,attention,and language,delayed recall and directional force among the three groups,and the OS group was lower than the pure COPD group and the pure OSAHS group（P<0.05）.The total score of Mo CA in the OS group were lower than those in the pure COPD and the pure OSAHS group,the differences were statistically significant（P<0.05）.7 The total score of Mo CA was negatively correlated with Age（r=-0.903,P=0.000）,AHI（r=-0.874,P=0.000）,NGAL（r=-0.586,P=0.000）,ET-1（r=-0.731,P=0.000）,and was positively correlated with Pa O₂（r=0.750,P=0.000）,FEV1%pred（r=0.548,P=0.001）,and LSa O₂（r=0.486,P=0.003）,while wasn’t correlated with PH,BMI,smoking index,years of education,FEV1/FVC and Pa CO₂.8Multiple factors regression analysis showed that: Recognitive function was influenced by age,ET-1,AHI,and Pa O₂.The regression equation was statistically significant for F=108.263,P=0.000<0.05,and the coefficient of determination R2=0.927,Regression coefficients and P were（-0.282,0.000）,（-0.127,0.038）,（-0.080,0.009）,（0.093,0.014）,respectively.Regression equation was Y= 46.779-0.282XAge-0.127XET-1-0.080XAHI+0.093XPO₂.PH,BMI,smoking index,years of education,FEV1/FVC,FEV1%pred,Pa CO₂,LSa O₂,and NGAL disappeared in the equation.Conclutions 1 The levels of NGAL and ET-1 were increased in patients with overlap syndrome.2 There were more severe cognitive dysfunction in patients with overlap syndrome.In addition,with the increase of NGAL and ET-1 levels,the cognitive fucnction of patients with the OS group was decreased.3 There were some factors may be associated with cognitive impairment in patients with overlap syndrome,such as age,hypoxia,AHI,and ET-1 level.