短期持续正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征伴2型糖尿病患者胰岛素敏感性的影响  

The effect of short-time continuous positive airway pressure treatment on insulin sensitivity in patients with obstructive sleep apnea-hypopnea syndrome and type 2 diabetes

作　　者：王红梅[1] 王林[2] 刘吉祥[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市人民医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2008年第13期597-599,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴2型糖尿病患者行UPPP前,应用短期(7 d)持续正压通气(CPAP)治疗对其胰岛素敏感性的影响。方法:选择由PSG确诊的中、重度OSAHS伴2型糖尿病并需要行UPPP的患者30例,记录其AHI及夜间最低血氧饱和度(LSaO2),采用稳态模式评估(HOMA)指数评估胰岛素的敏感性,行7d CPAP治疗后,复查PSG和计算HOMA指数,并与治疗前做比较。结果:经过7d CPAP治疗后,AHI及LSaO2明显改善(P<0.05),胰岛素敏感性升高(P<0.05);AHI与空腹胰岛素水平呈正相关(r=0.6365,P<0.05),与胰岛素敏感性呈负相关(r=-0.6229,P<0.05);夜间LSaO2与空腹胰岛素水平呈负相关(r=-0.8889,P<0.05),与胰岛素敏感性呈正相关(r=0.9526,P<0.05)。结论:短期CPAP治疗能改善OSAHS伴2型糖尿病患者夜间低血氧的情况,增加其胰岛素的敏感性,降低UPPP的危险性。Objective： To investigate the effects of short time continuous positive airway pressure treatment before the surgery on insulin sensitivity in patients with obstructive sleep apnea-hypopnea syndrome and type 2 diabetes who need the operation of uvulopalatophargngoplasty. Method： Thirty cases of patients with moderate and severe obstructive sleep apnea hypopnea syndrome and type 2 diabetes who need the operation of UPPP were included in this study. The apnea hypopnea index （AHI）and LSaO2 and the insulin sensitivity index（ISI） was evaluated by homeostasis model assessment （HOMA）, after 7 days of effective CPAP treatment. Subsequently, the data of the PSG and the ISI were rechecked and compared to the data previously achieved. Result：After 7 days of effective CPAP treatment, the level of AHI and LSaO2 changed （P〈0.05）. The level of ISI improved（P〈0.05）, while the level of AHI was correlated with fasting blood insulin level（r=0. 6365,P〈0.05） and was inverse correlated with insulin sensitivity （r= -0. 6229, P〈0.05）. There was an negative correlation between LSaO2 and fasting blood insulin level（r= -0. 8889, P〈0.05）, and there was a correlation between LSaO2 and insulin sensitivity（r= 0. 9526,P〈0.05）. Conclusion： The 7 days of effective CPAP treatment could improve the hypoxia of patients, and it could enhance the ISI and could reduce the operation risk of UPPP.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 2型糖尿病 持续正压通气 胰岛素敏感性 稳态模式评估指数 

分 类 号：R764[医药卫生—耳鼻咽喉科]