持续气道正压通气治疗OSAHS合并2型糖尿病的临床研究  

Clinical study on continuous positive airway pressure treatment for coexisting obstructive sleep apnea hypopnea syndrome and type 2 diabetes

作　　者：李为春[1] 丛俊华[1] 李丽[1] 孟华芳 刘俊[1] 钱华[1] 朱善勇[1] 朱先极 张希龙[2,3] 

机构地区：[1]江苏省泰州市第二人民医院呼吸科,225300 [2]南京医科大学第一附属医院 [3]江苏省人民医院呼吸科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2015年第2期109-111,114,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的评价经鼻持续气道正压通气治疗(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并2型糖尿病(T2D)患者的治疗效果。方法选取临床确诊T2D合并OSAHS的患者共58例,分为CPAP治疗组(n=28)和对照组(n=30),治疗组在给予T2D常规药物治疗的同时进行CPAP治疗,对照组仅给予常规药物治疗。观察两组患者治疗前及治疗30d后的体重指数(BMI)、呼吸暂停低通气指数(AHI)、最低及平均SaO_2、空腹血糖、血胰岛素、糖化血红蛋白(HbA1c)水平以及稳态模型胰岛素抵抗指数(HOMA-IR)的变化。结果对照组治疗前后各指标差异均无统计学意义(P>0.05);CPAP组治疗30d后与治疗前相比夜间AHI显著降低,最低及平均SaO_2明显增高(均为P<0.01),且空腹血糖明显降低(P<0.05),血胰岛素、Hb A1c水平及HOMA-IR均显著降低(均为P<0.05)。结论 CPAP治疗合并T2D的OSAHS不仅可有效纠正OSAHS本身,也可使伴随的T2D得到改善。Objective To evaluate the therapeutic effects of continuous positive airway pressure（CPAP） on patients with coexisting type 2 diabetes（T2D） and obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Fifty-eight patients with coexisting T2 D and OSAHS were divided into CPAP treatment group（n=28） and non-CPAP treatment group（control group, n=30）.Routing medication for T2 D was kept unchanged during the study period in both groups. Nasal CPAP was performed in CPAP treatment group. On day 30 of this study, comparison was made between two groups for the following parameters： body mass index（BMI）, apnea hyponea index（AHI）, nocturnal mean and minimal SaO2（mean SaO2 and mini Sa O2）, fasting blood glucose（FBG）, serum insulin, hemoglobin A1c（Hb A1c）, and HOMA-IR index. Results Compared with baseline parameters, on day 30 of the study, control group showed no significant difference in all observed parameters（P〉0.05）; while in CPAP treatment group, although BMI showed no significant changes（P〉0.05）, AHI was significantly decreased, nocturnal mean SaO2 and mini SaO2 significantly elevated, FBG, serum insulin, HbA1c, and HOMA-IR index were significantly declined（all P〈0.05）. Conclusion To patients with coexisting OSAHS and T2 D, CPAP treatment was effective not only to OSAHS itself but also to accompanied T2 D.

关 键 词：阻塞性睡眠呼吸暂停 持续气道正压通气 2型糖尿病 

分 类 号：R766[医药卫生—耳鼻咽喉科]