中年高血压合并阻塞性睡眠呼吸暂停综合征患者糖代谢的随访  

A survey on glucose metabolism disorder in middle-aged patients with hypertension complicated with obstructive sleep apnea syndrome

作　　者：石阿敏 姚晓光[1] 李南方[1] 努尔古丽·买买提[1] 祖菲亚·阿布利克木 SHI A-min;YAO Xiao-guang;LI Nan-fang;Nuerguli Maimaiti;Zufeiya Abulikemu(Department of Cardiology,The People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院高血压中心,新疆高血压研究所,新疆乌鲁木齐830001

出　　处：《中华全科医学》2020年第1期62-67,共6页Chinese Journal of General Practice

基　　金：新疆少数民族科技人才特殊培养计划(2016D0229);新疆维吾尔自治区人民医院院内科研项目(20160201).

摘　　要：目的观察阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)对中年高血压患者糖代谢的影响。方法选择2010年1—12月连续在新疆维吾尔自治区人民医院高血压科就诊的高血压患者,对怀疑有OSAS的患者行夜间多导睡眠监测,获得895例首次诊断OSAS的高血压患者。通过排除标准,选择年龄在40~60岁之间的中年人群进行随访。2017年获得完整随访数据306例,220例合并OSAS的高血压患者(分为轻、中、重度组),未合并OSAS的高血压患者86例。随访内容包括年龄、性别、血压、空腹血糖、糖化血红蛋白、诊断糖尿病的日期及使用降糖药物等,平均随访时间为(4.41±2.44)年。分析中年高血压患者,合并OSAS后发生糖代谢紊乱的情况,高血压合并不同严重程度的OSAS患者经过随访后空腹血糖及糖化血红蛋白水平的差异。结果在中年人群中,高血压合并OSAS组患者糖尿病发病率为18.6%,糖代谢紊乱的发病率为28.6%,均高于未合并OSAS组的高血压患者(8.1%,23.3%)。未合并OSAS组的高血压患者糖尿病前期的发病率(15.1%)高于合并OSAS组患者(10.0%)。结论高血压合并OSAS后更容易发生糖代谢紊乱,糖代谢紊乱的发生率与OSAS的严重程度正相关。Objective To observe the influence of obstructive sleep apnea syndrome(OSAS)on glucose metabolism in middle-aged hypertensive patients.Methods The whole-night polysomnography(PSG)was performed in the hypertensive patients suspected of OSAS in our department between January to December 2010,and 895 patients were confirmed.According to exclusion criteria,middle-aged people aged between 40 and 60 were selected for follow-up.A total of 306 complete follow-up data were collected in 2017,including 86 patients without OSAS and 220 patients with OSAS(they were divided into mild,moderate and severe groups according to sleep respiratory disorder index(AHI)of OSAS patients).The follow-up included age,sex,blood pressure,fasting blood sugar,glycosylated hemoglobin,date of diabetes diagnosis and use of hypoglycemic drugs.The average follow-up time was(4.41±2.44)years.The incidence of glycometabolism disorder,the average fasting blood glucose and glycosylated hemoglobin level were compared among the different groups.Results Among middle-aged people,the incidence of diabetes mellitus and glucose metabolism disorder was 18.6%and 28.6%respectively in patients with hypertension and OSAS,which were higher than those in hypertension patients without OSAS(8.1%and 23.3%).The incidence of pre-diabetes in hypertension patients without OSAS(15.1%)was higher than that in hypertension patients with OSAS(10.0%).Conclusion The glycometabolism disorder is more likely to occur in hypertensive patients with OSAS.The incidence of glycometabolism disorder is positively correlated with the severity of OSAS.

关 键 词：阻塞性睡眠呼吸暂停综合征 高血压 葡萄糖代谢障碍 

分 类 号：R766[医药卫生—耳鼻咽喉科] R544.1[医药卫生—临床医学]