阻塞型睡眠呼吸暂停综合征与胰岛素抵抗的关系  

Relationship between obstructive sleep apnea syndrome and insulin resistance

作　　者：王香[1] 邵萍 牛文明[1] 徐克炜[1] 

机构地区：[1]宁夏回族自治区银川市第一人民医院睡眠中心,宁夏医学院第二附属医院,750001

出　　处：《临床内科杂志》2002年第3期210-212,共3页Journal of Clinical Internal Medicine

基　　金：宁夏回族自治区科技攻关项目 (990 350Y0 57E)

摘　　要：目的　探讨阻塞型睡眠呼吸暂停综合征 (OSAS)低氧与胰岛素抵抗之间的关系及持续正压通气 (CPAP)治疗OSAS对胰岛素抵抗的影响。方法　分析 6 1例OSAS患者CPAP治疗前后及 16例未治疗OSAS患者多导睡眠监测各项指标与空腹血糖、胰岛素和餐后 2h血糖、胰岛素的关系 ,另选择 5 6例不符合SAS诊断者为对照组。结果　OSAS组治疗前呼吸紊乱指数 ( 36 .4±18.2 )次 /h ,最低氧饱和度 ( 74.5± 6 .2 ) % ,餐后血糖 ( 10 .6± 2 .4)mmol/L ,餐后胰岛素 ( 6 9.7±2 7.7)uIU/ml,胰岛素敏感性 ( 0 .8± 0 .2 )。CPAP治疗第 10天复查上述各项指标结果分别为 ( 3.3± 3.4)次 /h、( 86 .5± 1.3) %、( 7.2± 0 .6 )mmol/L、( 39.7± 10 .2 ) μIU/ml、1.2± 0 .2。P值分别 <0 .0 1、<0 .0 1、<0 .0 5、<0 .0 1、<0 .0 1。结论　OSAS组治疗前血浆胰岛素和血糖比对照组高 ,治疗后OSAS组比未治疗组低。表明OSAS低氧可产生胰岛素抵抗。Objective To investigate the relationship between obstructive sleep apnea syndrome(OSAS) hypoxemia and insulin resistance(IR),and the effectiveness of continuous positive airway pressure(CPAP) to OSAS and IR.Methods Sixty one patients of OSAS were treated by CPAP.All index of the nocturnal polysomnography,insulin and blood sugar in empty stomach,insulin and blood sugar 2 hours after meal were analysed Before and after treatment,and in 16 patients of OSAS untreated by CPAP.The other 56 cases of non OSAS were treated as control group.Results In OSAS group,before treatment AHI was(36.4±18.2)times/h,LSaO 2(74.5±6.2)%,blood sugar after meal(10.6±2.4) mmol/L,insulin after meal(69.7±27.7) μIU/ml,insulin sensitivity (0.8±0.2),10 days after treatment,all indlces above changed as following(3.3±3.4)times/ hour,(86.5±1.3)%,(7.2±0.6) mmol/L,(39.7±10.2) μIU/ml,(1.2±0.2), P <0.01, P <0.01, P <0.05, P <0.01, P <0.01,respectively.Conclusion Before CPAP treatment,the levels of blood sugar and insulin in OSAS group are higher than those of control group,after CPAP treatment,the levels of blood sugar and insulin in OSAS group are lower than those in OSAS group untreated by CPAP.It showed that OSAS hypoxemia may develop IR.

关 键 词：阻塞型睡眠呼吸暂停综合征 胰岛素抵抗 正压通气 治疗 

分 类 号：R56[医药卫生—呼吸系统]