影响T2DM合并OSAS患者睡眠呼吸障碍程度的多因素分析  

The Multiple-factor Analysis of Sleep Apnea in the Patients Diagnosed as T2DM Combined OSAS

作　　者：王丽英[1] 王顺花 苏伟娟[1] 刘长勤[1] 李学军[1] 杨叔禹[1] Wang Liying;Wang Shunhua;Su Weijuan;Liu Changqin;Li Xuejun;Yang Shushu(First hospital affiliated to Xiamen university,Xiamen,361001)

机构地区：[1]厦门大学附属第一医院内分泌糖尿病科,厦门361001

出　　处：《世界睡眠医学杂志》2018年第8期887-890,共4页World Journal of Sleep Medicine

摘　　要：目的:探讨影响T2DM合并OSAS患者呼吸障碍程度的危险因素;运用中医证素辨证方法,探讨痰证素的作用。方法:纳入135例本院内分泌糖尿病科住院且以T2DM为第一诊断的患者,据AHI分为无OSAS组、轻度OSAS组、中度OSAS组和重度OSAS组,采集相关资料。结果:1)与无、轻度、中度OSAS组比较,重度OSAS组在BMI、腰臀比、颈围、痰证素积分上高于其他3组,而Hb A1c则较其他3组低,差异均有统计学意义(P<0.05或P<0.01);中度、重度OSAS组UA明显高于无、轻度OSAS组,差异有统计学意义(P<0.05或P<0.01)。2)以BMI、腰臀比、颈围为控制变量,偏相关分析显示AHI与Hb A1c呈负相关(r=-0.260,P<0.05),与UA、痰证素积分呈正相关(r=0.219、0.190,P<0.05)。3)BMI、Hb A1c、UA、痰证素积分是影响AHI的重要因素。结论:1)BMI、Hb A1c、UA是评估T2DM合并OSAS患者呼吸障碍程度的重要预测指标;其中,BMI、UA与呼吸障碍程度呈正相关,而Hb A1c则为负相关,且独立于肥胖之外;2)痰证素可作为中医判断T2DM合并OSAS的一个危险因素。Objective： Observe the multiple-factor to Sleep apnea in the patients diagnosed as T2 DM combined OSAS. Use the method of syndrome element differentiation in Traditional Chinese medicine to explore the effect of phlegm. Methods： A total of 135 cases were selected from March 2015 to February 2016 were divided into Without OSAS group,Mild OSAS group,Moderate OSAS group,Severe OSAS group,Collect the relevant data. Results： 1） Compared with the Without OSAS、Mild OSAS、Moderate OSAS group,the Severe OSAS group BMI、WHR、neck circumference、Phlegm score is higher,but Hb A1 c is lower than other 3 groups,has significant differences（ P〈0. 05 or P〈0. 01）.UA is obviously higher in Moderate OSAS group and Severe OSAS group than the Without OSAS group and Mild OSAS group; 2） Taking BMI,waist-hip ratio and neck circumference as control variables,partial correlation analysis showed that AHI was negatively correlated with Hb A1 c. Conclusion： 1） BMI,Hb A1 c and UA are important predictors to evaluate the degree of respiratory disorder in patients with T2 DM and OSAS. BMI and UA were positively correlated with the degree of respiratory disorder,while Hb A1 c was negatively correlated and independent of obesity; 2） Phlegmon can be used as a risk factor for the diagnosis of T2 DM with OSAS in Chinese medicine.

关 键 词：2型糖尿病 阻塞性睡眠呼吸暂停综合征 多因素 痰证素 

分 类 号：R587.1[医药卫生—内分泌] R441.8[医药卫生—内科学]