阻塞性睡眠呼吸暂停低通气综合征对老年2型糖尿病患者糖尿病肾病进程的影响  

Effect of obstructive sleep apnea hypopnea syndrome on the course of diabetic nephropathy in elderly type 2 diabetic patients

作　　者：唐珊 张日东[1] 袁琦 毛莉[1] TANG Shan;ZHANG Ridong;YUAN Qi;MAO Li(Department of Endocrinology,Huaian First People’s Hospital Affiliated to Nanjing Medical University,Jiangsu Province,Huaian223300,China)

机构地区：[1]南京医科大学附属淮安第一人民医院内分泌科,江苏淮安223300

出　　处：《中国医药导报》2021年第36期77-80,共4页China Medical Herald

基　　金：江苏省卫生健康委员会项目(H2018085)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对老年2型糖尿病(T2DM)患者糖尿病肾病进程的影响。方法选择2018年2月至2020年3月南京医科大学附属淮安第一人民医院收治的145例T2DM患者为研究对象。统计T2DM患者合并肾病情况,并据此分为糖尿病肾病组和单纯糖尿病组。比较两组临床资料。logistic多因素回归分析影响T2DM肾病发生的影响因素。结果本研究145例T2DM患者糖尿病肾病的发生率为26.21%。糖尿病肾病组糖尿病病程、血糖标准差(SDBG)、日平均血糖波动幅度、日间血糖平均绝对值(MODD)、尿白蛋白、血肌酐(Scr)及呼吸暂停低通气指数(AHI)高于单纯糖尿病组(P<0.05),肾小球滤过率估算值(eGFR)、夜间最低脉氧饱和度(LSPO_(2))则低于单纯糖尿病组(P<0.05)。logistic多因素分析结果显示,MODD、eGFR、AHI及LSPO_(2)均为老年T2DM患者糖尿病肾病发生的影响因素(OR=1.992、0.826、4.204、0.753,P<0.05)。结论SDBG、MODD、AHI及LSPO_(2)均为老年T2DM患者糖尿病肾病发生的影响因素,OSAHS可促进老年T2DM患者糖尿病肾病进程。Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome(OSAHS)on the progression of diabetic nephropathy in elderly type 2 diabetes mellitus(T2DM)patients.Methods A total of 145 T2DM patients admitted to Huaian First People’s Hospital Affiliated to Nanjing Medical University from February 2018 to March 2020 were selected as the study subjects.T2DM patients with nephropathy were statisticsed and they were divided into diabetic nephropathy group and simple diabetes group according to the status of T2DM patients with nephropathy.The clinical data of two groups were compared.The factors affecting the occurrence of T2DM nephropathy were analyzed by logistic multifactor regression.Results In this study,the incidence of diabetic nephropathy in 145 T2DM patients was 26.21%.The course of diabetes,standard deviation of blood glucose(SDBG),mean amplitude of glycemic excursions,mean absolute value of daytime blood glucose(MODD),urinary albumin,serum creatinine(Scr),and apnea hypoventilation index(AHI)in diabetic nephropathy group were higher than those in simple diabetic group(P<0.05).The estimated glomerular filtration rate(eGFR)and night minimum pulse oxygen saturation(LSPO2)were lower than those in the simple diabetic group(P<0.05).Logistic multivariate analysis showed that MODD,eGFR,AHI,and LSPO_(2) were all influencing factors of diabetic nephropathy in elderly T2DM patients(OR=1.992,0.826,4.204,0.753,P<0.05).Conclusion SDBG,MODD,AHI and LSPO_(2) are all influencing factors affecting the occurrence of diabetic nephropathy in elderly patients with T2DM.OSAHS can promote the progress of diabetic nephropathy in elderly patients with T2DM.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 老年 2型糖尿病 糖尿病肾病 

分 类 号：R582.7[医药卫生—内分泌]