持续气道内正压通气治疗阻塞性睡眠呼吸暂停综合征前后血清瘦素及胃饥饿素的变化  

Changes of ghrelin and leptin levels in patients with obstructive sleep apnea syndrome before and after treatment of continuous positive airways pressure

作　　者：王实[1] 鲁刚[1] 陈雷[1] 吴艺虹[1] 夏书月[1] 

机构地区：[1]沈阳医学院附属中心医院呼吸内科,辽宁沈阳110024

出　　处：《中国实用内科杂志》2006年第7期1001-1003,共3页Chinese Journal of Practical Internal Medicine

基　　金：辽宁省科技厅资助项目(2004225003-10)

摘　　要：目的为观察阻塞性睡眠呼吸暂停综合征(OSAS)患者在持续气道内正压通气(CPAP)治疗前后血清瘦素和胃饥饿素的变化。方法选择沈阳医学院附属中心医院2004年4月至2005年9月收治的20例OSAS患者。诊断符合中华医学会呼吸学会睡眠学组制定的标准。CPAP治疗前及治疗1周后、6个月后进行空腹血糖(FBG)、真胰岛素(TI)、瘦素和胃饥饿素的测定。结果CPAP治疗1周后,血浆胃饥饿素,瘦素有所下降,但FBG和TI无明显变化。CPAP治疗6个月后,胃饥饿素及瘦素水平明显下降。FBG和TI也有所下降。CPAP治疗有效地改善睡眠呼吸紊乱及低氧状态,生活质量明显提高。结论血清瘦素、胃饥饿素水平通过长期CPAP治疗可明显下降。CPAP长期治疗可以改善OSAS的糖代谢和胰岛素抵抗。因此,OSAS可能是导致胃饥饿素和瘦素代谢紊乱引起体重增加,导致肥胖原因之一。Objective To evaluate the change of ghrelin and leptin levels in patients with obstructive sleep apnea syndrome （OSAS） before and after continuous positive airways pressure （CPAP）. Methods Male patients （ n = 16 ） and female patients （ n = 4） with OSAS （ index = AHI 〉 30, BMI ≥ 25 kg·m^-2 ）, who were admitted to the hospital from Apr. 2004 to Sep. 2005, were induded in the study. They underwent CPAP. The PSG and leptin, ghrelin, true insulin, fasting blood glucose are measured before the treatment, and one week and six months after the treatment. Results After one week, there was a little decrease of leptin and ghrelin, and no change in true insulin and fasting blood glucose. After six months, only 16 patients improved a lot in AHI and hypoxemia. There was significant decrase of leptin and ghrelin and also a change of true insulin. Conclusion These data indicate that the elevated leptin and ghrelin levels are not determined by obesity alone, since they decrease during CPAP therapy. The glucose metabolic disturbance and insulin resistance in OSAS are improved after 6 months of CPAP therapy. Therefore, we can think that OSAS patients have metabolic disturbance of leptin and ghrelin, which is one of factors of obesity.

关 键 词：瘦素 胃饥饿素 阻塞性睡眠呼吸暂停综合征 持续气道内正压通气 

分 类 号：R5[医药卫生—内科学]