阻塞性睡眠呼吸暂停低通气综合征患者糖耐量受损69例  

Clinical analysis of 69 obstructive sleep apnea hypopnea syndrome patients with impaired glucose tolerance

作　　者：秦永欣[1] 刘鸿源[1] 王林[1] 刘吉祥[1] 王红梅[1] 韦升利[1] 

机构地区：[1]天津市人民医院耳鼻咽喉科,天津300121

出　　处：《中国眼耳鼻喉科杂志》2008年第5期289-291,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)与糖耐量受损(impaired glucose tolerance,IGT)的关系。方法单纯OSAHS患者205例,OSAHS合并IGT者69例,OSAHS合并2型糖尿病者46例,健康对照组86例,检测患者体质量指数、呼吸暂停低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度(lowest artery oxygen saturation,LSaO2)、收缩压、舒张压、红细胞数、甘油三脂、总胆固醇、空腹血糖、口服75 g葡萄糖2 h后血糖。OSAHS合并IGT者行悬雍垂腭咽成形术或鼻腔持续正压通气治疗,该组患者均未用降血糖药物治疗。结果OSAHS各组与健康对照组比较,LSaO2下降,体质量指数等其他指标均明显升高,差异均有统计学意义(P<0.05)。OSAHS各组间体质量指数等观察指标差异均无统计学意义(P>0.05)。OSAHS合并IGT组空腹血糖及口服75 g葡萄糖2 h后血糖分别与体质量指数、AHI、甘油三酯及总胆固醇水平呈正相关(P<0.05),与LSaO2水平呈负相关(P<0.01),与红细胞数、收缩压及舒张压水平无明显相关性。OSAHS合并IGT组患者治疗半年后与治疗前比较:体质量指数及舒张压下降,但差异无统计学意义(P>0.05);其他指标均有所改善,差异有统计学意义(P<0.05)。结论OSAHS可并发糖代谢紊乱,其IGT与体质量指数、AHI、LSaO2、甘油三脂、总胆固醇水平相关,治疗OSAHS后,IGT可好转。Objective To investigate the relationship between obstructive sleep apnea hypopnea syndrome （OSAHS） and impaired glucose tolerance （IGT）. Methods Body mass index（BMI）, apnea hypopnea index （AHI）, lowest artery oxygen saturation（ LSaO2 ）, systolic blood pressure （ SBP ）, diastolic blood pressure （ DBP ）, red blood cell （ RBC ）, triglyeride （ TG ）, total cholesterol （ TC ）, fasting plasma glucose （FPG） and plasma glucose 2 hours after oral gloeose（2hPG） was detected in 205 OSAHS patients, 69 OSAHS with IGT, 46 OSAHS with type 2 diabetes, and 86 norreal controls. Sixty-nine OSAHS patients combined with IGT who accepted no medicine treatment underwent uvulopalatopharyngoplasty or nasal continuous positive airway pressure treatment. Six months after the treatment, the index mentioned above were reexamed. Results Compared with the normal control group, the BMI, AHI, SBP, DBP, RBC ,TG and TC increased in all OSAHS groups（P 〈0.05）, LSaO2 decreased significantly （P 〈0.05）. Among the OSAHS groups, no significant changes were found in the BMI, AHI, LSaO2 , SBP, DBP, RBC,TG or TC （ P 〉 0.05 ）. FPG,2hPG in OSAHS combined with IGT group was positively correlated with BMI,AHI,TG and TC, negatively correlated with LSaO2. There was a negative correlation between LSaO2 and FPG, 2hPG, and no significant correlation between FPG,2hPG and RBC, SBP, DBP respectively. Six months after the treatment, AHI, LSaO2 ,SBP, RBC ,TG ,TC, FPG ,2hPG in OSAHS combined with IGT group was all improved significantly （P 〈 0.05 ） ; while BMI and DBP was decreased （P 〉 0.05 ）. Conclusions OSAHS could occur with the disturbance of glycometabolism and IGT was correlated with the BMI, AHI,TG, TC and LSaO2. Therapy for OSAHS was helpful for the improvement of IGT. （Chin J Ophthalmol and Otorhinolaryngol,2008,8： 289-291 ）

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 糖耐量受损 治疗 

分 类 号：R766[医药卫生—耳鼻咽喉科] R587.1[医药卫生—临床医学]