2型糖尿病合并OSAS患者AHI与血管损伤标志物的相关性  

Correlation between AHI and vascular injury markers in patients with type 2 diabetes mellitus complicated with OSAS

作　　者：侯玮琼[1] 杨勋超 姜北[1] 赵岩[1] 毛文超 王师菡[2] HOU Weiqiong;YANG Xunchao;JIANG Bei;ZHAO Yan;MAO Wenchao;WANG Shihan(Department of Cardiovascular,South District of Guang’anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 102618,China;Department of Cardiovascular,Guang’anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院南区心血管科,北京102618 [2]中国中医科学院广安门医院本部心血管科,北京100053

出　　处：《安徽医学》2022年第10期1157-1161,共5页Anhui Medical Journal

摘　　要：目的探究2型糖尿病合并阻塞性睡眠呼吸暂停综合征(OSAS)患者睡眠呼吸暂停低通气指数(AHI)与血管损伤标志物的相关性。方法选取2019年4月至2021年4月中国中医科学院广安门医院南区收治的2型糖尿病合并OSAS患者85例作为OSAS组,及同期收治的单纯2型糖尿病患者88例作为无OSAS组。采用多导睡眠监测仪监测患者AHI、氧减指数(ODI)、最低血氧饱和度(L-SaO_(2)),并根据AHI结果将85例2型糖尿病合并OSAS患者分为轻度OSAS组(33例)、中度OSAS组(28例)和重度OSAS组(24例)。采用酶联免疫吸附(ELISA)法检测其血清可溶性血管细胞黏附分子1(sVCAM-1)、内皮素-1(ET-1)、血管性血友病因子(vWF)水平。采用Pearson检验分析2型糖尿病合并OSAS患者AHI、ODI、L-SaO_(2)与血管损伤标志物sVCAM-1、ET-1、vWF的关系。结果OSAS组患者AHI、ODI及血清sVCAM-1、ET-1、vWF水平明显高于无OSAS组(P<0.05),L-SaO_(2)明显低于无OSAS组(P<0.05)。重度、中度OSAS组患者血清sVCAM-1、ET-1、vWF水平明显高于轻度OSAS组(P<0.05),重度OSAS组患者血清sVCAM-1、ET-1、vWF水平明显高于中度OSAS组(P<0.05)。2型糖尿病合并OSAS患者AHI与血清sVCAM-1、ET-1、vWF水平均呈正相关(r=0.390、0.405、0.368,P<0.05),ODI与血清sVCAM-1、ET-1、vWF水平均呈正相关(r=0.395、0.412、0.381,P<0.05),L-SaO_(2)与血清sVCAM-1、ET-1、vWF水平均呈负相关(r=-0.394、-0.401、-0.374,P<0.05)。结论2型糖尿病合并OSAS患者AHI与sVCAM-1、ET-1、vWF密切相关,参与病情进展,且可能与血管内皮细胞损伤程度有关。Objective To explore the correlation between apneahypopnea index(AHI)and vascular injury markers in patients with type 2 diabetes mellitus complicated with obstructive sleep apnea syndrome(OSAS).Methods Eighty-fivepatients with type 2 diabetes mellitus complicated with OSAS who were admitted to the South District of Guang’anmen Hospital,Chinese Academy of Traditional Chinese Medicinefrom April 2019 to April 2021 were selected as OSAS group,and 88 patients with simple type 2 diabetes mellitus treated in the same period were selected as non OSAS group.The AHI,oxygen desaturation index(ODI)and lowest oxygen saturation(L-SaO_(2))were monitored by polysleep monitor.According to the results of AHI,85 patients with type 2 diabetes combined with OSAS were divided into mild OSAS group(33 cases),moderate OSAS group(28 cases)and severe OSAS group(24 cases).Enzyme linked immunosorbent assay(ELISA)wasapplied to detect the serum levels of soluble vascular cell adhesion molecule 1(sVCAM-1),endothelin-1(ET-1)and von willebrand factor(vWF).Pearson test was used to analyze the relationship between AHI,ODI,L-SaO_(2) and vascular injury markerssVCAM-1,ET-1,vWF in patients with type 2 diabetes mellitus complicated with OSAS.Results The levels of AHI,ODI,serum sVCAM-1,ET-1 and vWF in OSAS group were significantly higher than those in non OSAS group(P<0.05),and L-SaO_(2) was significantly lower than those in non OSAS group(P<0.05).The levels of serum sVCAM-1,ET-1 and vWF in severe and moderate OSAS group were significantly higher than those in mild OSAS group(P<0.05);the levels of serum sVCAM-1,ET-1 and vWF in severe OSAS group were significantly higher than those in moderate OSAS group(P<0.05).There was a positive correlation between AHI and serum sVCAM-1,ET-1 and vWF levels in type 2 diabetic patients with OSAS(r=0.390,0.405,0.368,P<0.05),ODI was positively correlated with the levels of serum sVCAM-1,ET-1 and vWF(r=0.395,0.412,0.381,P<0.05),andL-SaO_(2) was negatively correlated with serum sVCAM-1,ET-1 and vWF levels(r=-0.394,-0.40

关 键 词：2型糖尿病 阻塞性睡眠呼吸暂停综合征 血管损伤标志物 相关性 

分 类 号：R766[医药卫生—耳鼻咽喉科] R587.2[医药卫生—临床医学]