机关老年人阻塞性睡眠呼吸暂停与代谢综合征关系初探  

Relationship between obstructive sleep apnea and metabolic syndrome in elderly patients of government offices

作　　者：丁明[1] 顾建华[1] 刘剑南[1] 吴颖[1] 陆甘[1] 

机构地区：[1]江苏省老年医院呼吸科,江苏省南京市210024

出　　处：《实用老年医学》2013年第3期237-239,共3页Practical Geriatrics

基　　金：南京市科技局科技发展项目(200504020)

摘　　要：目的调查和分析>60岁机关打鼾人群中阻塞性睡眼呼吸暂停综合征(OSAS)与代谢综合征(MS)的关系。方法 采用整群抽样法,2008年10月至2009年4月,在我院体检中心接受健康体检的>60岁的机关打鼾者共156例纳入研究。现场完成抽样问卷调查,并完成夜间7h多导睡眠仪(PSG)监测,按呼吸暂停低通气指数(AHI)将156例分为Ⅰ组(AHI≤5)、Ⅱ组(AHI>5)。全部进行口服葡萄糖耐量试验(OGTT)并测定空腹葡萄糖、空腹胰岛素、餐后2h血糖、总胆固醇(TC)、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇和尿酸。计算HOMA指数、体质量指数(BMI)。结果 该组打鼾者ESS评分0～20分,中位分值为5分。156例中Ⅰ组119例,占总数76.3%;Ⅱ组37例,占总数23.7%。经比较2组间各指标和疾病状态,具有显著性差异的是:腰围、BMI、相关症状得分、TC、LDL-C、血糖水平和HOMA指数、MS和脑血管病(P均<0.05)。结论 >60岁机关打鼾人群中OSAS患者,具有更多的MS的危险因素和显著的胰岛素抵抗,脑血管疾病患病率更高,临床症状更为严重。需要社会高度重视对>60岁打鼾人群的OSAS筛查和防治,同时对OSAS高危人群主张早期干预。Objective To investigate and analyse the relationship between obstructive sleep apnea syndrome(OSAS) and metabolic syndrome(MS) in elderly patients of government offices with snoring symptom.Methods Using cluster sampling method,from October 2008 to April 2009,156 patients with snoring symptom of government offices aged over 60 were enrolled in the study,156 patients underwent polysomnography(PSG)and were divided into group Ⅰ(AHI≤5)and groupⅡ(AHI>5),and evaluated Ep-worth sleepiness score(ESS).The levels of test fasting glucose,fasting insulin,postprandial two hours blood glucose,cholesterol,triglycerides,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol and uric acid were detected.HOMA index and BMI were calculated.Results The ESS score was 0~20 in the snorers with a median score of 5.Out of 156 patients,119 patients were in group Ⅰ(76.3%),37 patients were in group Ⅱ(23.7%).Between the two groups,there were significant differences in waistline,BMI,symptom score,total cholesterol(CH),low-density lipoprotein cholesterol(LDL-C),blood glucose levels,HOMA index,MS and cerebrovascular disease(P<0.05).Conclusions The patients with OSAS of government offices aged over 60 have more MS risk factors and significant insulin resistance,higher prevalence of cerebrovascular disease,more severe clinical symptoms.It is important to screen and prevent OSAS for the patients of government offices aged over 60 with snoring symptom,and to intervene OSAS high-risk groups early.

关 键 词：老年人 打鼾 睡眠呼吸暂停 代谢综合征 

分 类 号：R563.9[医药卫生—呼吸系统] R589[医药卫生—内科学]