2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征的临床分析  

Analysison the Clinical Feature of Obstructive Sleep Apnea Syndrome in Patients with Type 2 Diabetes Mellitus

作　　者：李伟[1] 张勤[1] 袁南兵[1] 陈辉[1] 

机构地区：[1]成都市第一人民医院内分泌科,四川成都610016

出　　处：《四川医学》2015年第5期621-624,共4页Sichuan Medical Journal

基　　金：四川省卫生厅2011年科研课题(编号:110005)

摘　　要：目的了解住院的2型糖尿病患者中阻塞性睡眠呼吸暂停综合征(OSAS)的临床特征。方法采用便携式睡眠监测仪对住院的2型糖尿病进行检测,按照测定结果将合并OSAHS者纳入试验组,试验组按病程长短分为初诊组以及非初诊组,将同期住院的非糖尿病伴OSAHS者为对照组,对两组进行颈围(cm)、腰围(WC)、腰/臀、体重指数(BMI)、血压(Kpa)、空腹血糖(FPG)、餐后2小时血糖(2h PPG)、糖化血红蛋白(Hb1Ac)、空腹胰岛素(FIns)、餐后2小时胰岛素(2h Ins)、空腹C肽(0h C肽)、2h C肽(2h C肽)、胰岛素抵抗指数(HOME-IR)、胰岛素分泌指数(HOME-β)、血脂、呼吸暂停-低通气指数(AHI)、最低血氧饱和度(LSp O2%)等的测定并等进行比较,并了解各组中高血压、冠心病的发病情况。结果两组体重指数(BMI)、腰围均高于正常,差异无统计学意义,但试验组有更粗的腰围和颈围,早发组更甚,但差异无统计学意义(P>0.05);试验组的空腹血糖(FPG)、餐后2小时血糖(PPG)、糖化血红蛋白(Hb1Ac)均高于对照组(P<0.05),初诊组胰岛素抵抗指数(HOME-IR)高于对照组(P<0.05);对照组以中重度OSAHS为主,试验组以轻中度OSAHS为主,但试验组血氧饱和度(LSp O2%)低于对照组,且非初诊组更低(P<0.05);高血压、冠心病的患病率试验组高于对照组(P<0.05)。结论糖尿病合并OSAHS缺氧更明显,心血管并发症更多。Objective To investigate the clinical feature of obstructive sleep apnea syndrome （OSAHS） in patients with type 2 diabetes mellitus for better understanding the relationship of DM with OSAHS. Methods According to polysomnographic examination, 47 DM patients with OSAHS were grouped into the observation group . Among the observation group, DM patients were divided in to the incipient diagnosed group and the non-incipient diagnosed group. The other 21 no-DM patients with OSAHS were grouped into the control group. General conditions, blood pressure（ BP）, fasting plasma glucose（FPG） ,2h-postprabdial plas- ma glucose （2h-PPG） , 0h-C-Peptide （Oh-CP）, 2h-C-Peptide （2h-CP） , glycohemoglobin （ HbA 1~ ）, fasting insulin （ FINS）, 2h-postprabdial insulin （ 2h-PINS ）, homeostasismodelassessmentindexofinsulinresistance （ HOMA-IR ）, homeostasismodelassess- ment-B （HOMA-13）, blood lipid, apnea hyponea index（ AHI）, lowest oxygen saturation（ LSPO2 ）were detected and compared. And then, comparingthehypertensionand coronary heart disease（CHD） conditionsin twogroups. Results The body mass index （BMI）, waist circumference in two groups were higher than those of healthy human beings （ P 〉 0.05 ）. The waist circumference and neck circumference in the observation group were higher than those in the control group. （ P 〉0. 05 ）. FPG, PPG, Hbl Ac in the obser- vation group were higher when compared with the control group. HOME-IR in the incipient diagnosed group was higher compared with the control group （P 〈 0. 05 ） ;while HOME- 8 was lower（ P 〉 0. 05 ）. In fact , HOME- $ andLSpO2% were lowest in the non-incipient diagnosed group （P 〈 0. 05） ;Hypertension in the observation group was significantly higher than in the control group （P 〈 O. 05 ）. Conclusion the possibility of incidence of hypertension increased in DM patients with OSAHS who lacked oxygen obviously.

关 键 词：糖尿病2型 睡眠呼吸暂停 阻塞性 胰岛素抵抗指数 高血压 

分 类 号：R587.1[医药卫生—内分泌]