阻塞性睡眠呼吸暂停综合征与胰岛素抵抗相关性的荟萃分析  

Obstructive sleep aponea syndrome, glucose intolerance and insulin resistance-a systematical review

作　　者：顾洁[1] 陈小东[2] 

机构地区：[1]上海复旦大学附属华山医院老年科,200040 [2]上海复旦大学附属华山医院呼吸科

出　　处：《国际呼吸杂志》2009年第23期1409-1417,共9页International Journal of Respiration

摘　　要：目的 通过荟萃分析总结阻塞性睡眠呼吸暂停综合征（obstructive sleep aponea syndrome，OSAS）和胰岛素抵抗（insulin resistance，IR）的相关性的循证医学证据。方法检索中西文数据库，对入选文献做资料提取，并总结分析。结果共有61篇文献入选，英文40篇，中文21篇。其中关于OSAS患者睡眠呼吸紊乱与糖尿病或IR相关性的流行病学调查或临床研究35项，25项研究认为0sAs严重程度与糖尿病或IR独立相关。此外，关于CPAP治疗是否能改善OSAS患者IR的临床研究共26篇，14项发现CPAP治疗后OSAS患者IR有所改善，但大部分研究未设对照组。结论OSAS和IR之间存在独立相关性，CPAP治疗是否能改善OSAS患者IR有待大样本量的随机双盲对照研究来确认。Objective To systematically review the evidence for the link between obstructive sleep aponea syndrome （OSAS）, glucose intolerance, and insulin resistance （IR）. Methods Searches of MEDLINE,OVID,ELSEVIER,CNKI and WANFANG data were performed for OSAS and IR. Results Sixty-one articles met the inclusion criteria（40 with English and 21 with Chinese）. 25 of 35 studies which have used objective measures of OSAS provide support for an independent link between OSAS, glucose intolerance,and IR. 14 of 26 studies that used continuous positive airway pressure（CPAP）to treat IR indicated that CPAP was effective, but most of them did not have control group. Conclusions OSAS is independently associated with glucose intolerance and IR. However, randomized controlled studies of large sample are needed to identified the improvement of metabolic disturbance after treatment.

关 键 词：阻塞性睡眠呼吸暂停综合征 胰岛素抵抗 持续气道正压通气 

分 类 号：R766[医药卫生—耳鼻咽喉科]