高血压患者中睡眠结构与血糖水平关系  

The relationship between Sleep architecture and glucose level

作　　者：李秀芳[1] 姚晓光[2] 邵亮[2] 李梅[1] 汪迎春[2] 李南方[2] 

机构地区：[1]石河子大学医学院临床医学系,新疆石河子832000 [2]新疆维吾尔自治区人民医院高血压中心新疆维吾尔自治区高血压研究所,乌鲁木齐830001

出　　处：《新疆医学》2016年第1期6-10,共5页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金项目(2015211C197)

摘　　要：目的探讨高血压患者中睡眠结构与血糖水平关系。方法连续入选2013年4月至2013年12月就诊于新疆维吾尔自治区人民医院高血压诊疗中心和睡眠监测中心的男性患者140例,所有受试者均采集一般临床资料、多导睡眠监测分析睡眠结构、测定血清空腹血糖、糖化血红蛋白等。根据呼吸暂停低通气指数(AHI),研究对象分为无、轻、中和重度OSAS四组,比较高血压患者伴随不同程度OSAS组间睡眠结构参数、血糖水平,分析高血压患者睡眠结构与血糖的关系。结果高血压伴重度OSAS组睡眠Ⅰ期较无OSAS组(6.78±3.40比9.42±7.43)、轻度OSAS组(6.19±3.51比9.42±7.43)明显缩短。与轻度OSAS组(5.57±0.35mmol/L)和中度OSAS组(5.61±0.30mmol/L)相比,合并重度OSAS患者糖化血红蛋白水平均明显较高(P值均<0.05)。在单纯高血压组中,空腹血糖水平与睡眠Ⅲ期存在负相关、与快动眼睡眠存在正相关。高血压合并重度OSAS组中发现糖化血红蛋白、空腹血糖水平与睡眠Ⅰ期正相关,空腹血糖与快动眼睡眠存在负相关(均P<0.05)。多元线性回归分析结果显示睡眠Ⅰ期时间百分比是影响空腹血糖、糖化血红蛋白水平的因素。结论高血压合并重度OSAS患者睡眠Ⅰ期时间百分比延长,糖化血红蛋白升高,提示男性患者中,高血压合并OSAS患者睡眠结构异常与血糖水平升高可能相关。Objective To study the relationship between Sleep architecture and glucose level. Methods A total of 140 male patients were recruited in the Center of Hypertension of the People＇s Hospital in Xinjiang Uygur Autonomous Region and Sleep monitoring center between April 2013 to December 2013. All patients underwent a full polysomnography（PSG）, fasting plasma glucose and glycohemoglobin measure. Patients were divided into non-OSAS, mild OSAS, moderate OSAS and severe OSAS group in accordance with Apnea hypopnea index（AHI）. Sleep architecture and glucose level were compared among different groups. Results Stage Ⅰ was significantly longer in severe OSAS group compared with non-OSAS（6.78 ±3.40 vs 9.42 ±7.43） and mild OSAS group（6.19 ±3.51vs9.42±7.43）. severe OSAS group（5.80±0.46mmol/L） had higher level of glycohemoglobin compared with mild OSAS group（5.57±0.35mmol/L） and moderate OSAS group（5.61 ±0.30mmol/L）（P〈0.05）. Fasting plasma glucose level of hypertension patients had a negative correlation with sleep stage Ⅲ and had a positive correlation with rapid-eye-movement sleep. A positive correlation was observed between sleep stageⅠand fasting plasma glucose level as well as glycohemoglobin in severe OSAS group, but a negative correlation existed between fasting plasma glucose level and rapid-eye-movement sleep. Multiple linear regression analysis showed that sleep stageⅠis an influenced factor of fasting glucose and glycohemoglobinn levels. Conclusion Hypertension patients with severe OSAS always have longer sleep stageⅠand higher glycohemoglobin, which prompts sleep architecture disorder and high glucose level.

关 键 词：高血压 血糖 睡眠结构 

分 类 号：R544.1[医药卫生—心血管疾病]