Effects Of Simultaneous Multi-level Surgery Intervention On The Changes Of The Oxidative Stress And Cognitive Function In Young And Middle-aged Patients With Moderate-severe OSAHS

Objective:To observe the change of the serum level of advanced oxidation and the cognitive function in young and middle-aged patients with Moderate-severe obstructive sleep apnea hypopnea syndrome(OSAHS), and then to investigate the correlation between them. To explore the effects of simultaneous multi-level surgery intervention on the changes of the Oxidative Stress and the cognitive function in young and middle-aged patients with Moderate-severe OSAHS.Methods:A total of 146 young and middle-aged patients(man 134,woman 12) were monitored by overnight polysomnography(PSG), in our hospital from December 2012 to December 2014,Based on the results of apnea-hypopnea index(AHI),they were divided into 2 groups of primary snoring(n=30)(compare group) and moderate-severe OSAHS(n=116)(OSAHS group),and the BMI and general condition of the two groups were matched. All 116 OSAHS patients accepted simultaneous multi-level surgery treatment.The questionnaires of Mini-Mental State Examinationand(MMSE),Montreal Cognitive Assessment(Mo CA) and Epworth Sleepiness Scale(ESS) were administered to assess cognitive function and daytime sleepiness.The serum levels of Malondialdehyde(MDA),Advanced Oxidation protein products(AOPP) and 8-isoprostane F2α(8-iso-PGF2α) were tested by Elisa method.The questionnaire scores,serum levels of MDA,AOPP,8-iso-PGF2αand PSG parameters were compared among 2 groups, explore the changesof the Oxidative Stress and the cognitive function before and after simultaneous multi-level surgery.Results : 1.Comparedto primary snoring group,the serum MDA((8.44±0.19)vs(4.07±0.25)nmol/m L),AOPP((108.90 ± 3.57)vs(41.05 ±0.97)μmol/L)and 8-iso-PGF2α((13.8±1.13)vs(6.3±1.81)ng/ml) levels increased significantly in OSAHS group(P<0.01).Comparedto primary snoring group, MMSE scoresand Mo CAscoresdecreased in OSAHS group,ESS scores increased in OSAHS group(P<0.05).Mo CA scores showed negative correlations with MDA, AOPP,8-iso-PGF2α,AHI,and TS90%and positive correlations with(LSa O2)(P<0.05),r=-0.256,-0.247,-0.221,-0.233,-0.190 and 0.215,respectively)。The evaluations of Mo CA subdomains further revealed selective reductions in visual space,executive function,attention and delayed memory function.2.The AHI,TS90% and TS90% were all improved significantly 6 months after operation.No severe complications were observed in any patient.The serum MDA((6.78±0.16)nmol/m L),AOPP((94.72±2.51)μmol/L)and 8-iso-PGF2α((8.10±2.11)ng/ml) levels decreased significantly after the surgery(P<0.05),MMSE scores((30.11±1.37)vs(26.54±1.07))and Mo CA scores((27.52±1.64)vs( 23.52±2.64)) increased after the surgery(P<0.05),ESS scores((9.02±4.20)vs(10.81±5.44)) decreased after the surgery(P<0.05), Mo CA scores after the surgery showed negative correlations with MDA、AOPP、8-iso-PGF2α、AHI、and TS90% and positive correlations with minimum oxygen saturation(P<0.05,r=-0.495、-0.463、-0.397、-0.332、-0.292 and 0.336,respectively).Conclusion:Oxidative Stress and Cognitive dysfunction are common in young and middle-aged patients with Moderate-severe OSAHS.Oxidative Stress may play an important role in cognitive dysfunction of young and middle-aged patients with Moderate-severe OSAHS.Multi-level surgery can improve Oxidative Stress so that to improve cognitive impairment.