持续气道正压通气治疗阻塞性睡眠呼吸暂停综合征对其胰岛素抵抗影响的meta分析  

Effects of continuous positive airway pressure on glucose control in obstructive sleep apnea and type 2 diabetes or IGT-a systematical review

作　　者：陈子盛[1] 傅应云[1] 刘盛国[1] 何正强[1] 

机构地区：[1]暨南大学第二临床医学院深圳市人民医院呼吸科,518020

出　　处：《国际呼吸杂志》2012年第5期351-355,共5页International Journal of Respiration

摘　　要：目的通过系统评价总结持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停综合征对其胰岛素抵抗影响的相关循证医学证据。方法关键词、主题词、引文追溯等途径检索Pubmed、Elsevier—SDOL、Embase、Foreign medical journals service、万方医学期刊库和中国学术期刊全文数据库，电子检索1990～2011年CPAP治疗睡眠呼吸暂停综合征（OSA）对其胰岛素抵抗影响的临床随机对照试验（RCT），逐一评价纳入研究的质量，提取人选文献资料，采用RevMan4．3软件进行meta分析。结果最终纳入4个RCT，共240例OSA患者，meta分析表明CPAP无显著改善OSA患者胰岛素抵抗作用（WMD=-0．29，95％CI-0．86-0．29，P=0．33），纳人文献表明CPAP干预不显著降低OSA患者空腹血糖、血浆胰岛素和糖化血红蛋白。结论CPAP治疗并没有改善OSA患者胰岛素抵抗、空腹血糖、血浆胰岛素及糖化血红蛋白水平作用。Objective To systematically review the evidence for the effect of CPAP on glucose control in obstructive sleep apnea patients. Methods Searches of Pubmed, Elsevier-SDOL, Google scholar,Foreign medical journals service and WAN FANG DATA,CNKI. Years between 1990 and Aug. 2011. As the research must be RCT study. Results Four articles met the inclusion criteria, for total 240 patients, Meta analysis supports that CPAP therapy changes nothing to insulin resistant （WMD= -0.29,95% CI ：-0.86-0.29, P =0.33）. Four in criteria articles point out that CPAP does not reduce the level of fasting glucose, plasma insulin and HbAlc. Conclusions The results suggest CPAP can not improve insulin resistant, fasting glucose, plasma insulin and H bAlc of obstructive sleep apnea patients.

关 键 词：阻塞性睡眠呼吸暂停综合征 持续气道正压通气 糖尿病 

分 类 号：R766[医药卫生—耳鼻咽喉科]