合并阻塞性睡眠呼吸暂停低通气综合征对老年人2型糖尿病视网膜病变的影响  

Effect of obstructive sleep apnea hypopnea syndrome on the progression of diabetic retinopathy in elderly patients

作　　者：杨莲 罗争 龚娇 Yang Lian;Luo Zheng;Gong Jiao(Department of Ophthalmology,Gucheng Country People's Hospital,Guchen 441700,Hubei Province,China;Department of Otolaryngology,Gucheng Country People's Hospital,Guchen 441700,Hubei Province,China;Department of Endocrinology,Gucheng Country People's Hospital,Guchen 441700,Hubei Province,China)

机构地区：[1]湖北省襄阳市谷城县人民医院眼科,441700 [2]湖北省襄阳市谷城县人民医院耳鼻喉科,441700 [3]湖北省襄阳市谷城县人民医院内分泌科,441700

出　　处：《中华老年病研究电子杂志》2022年第3期33-36,共4页Chinese Journal of Geriatrics Research(Electronic Edition)

摘　　要：目的探讨合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对老年2型糖尿病视网膜病变(DR)患者的影响。方法选取2020年3月至2021年3月谷城县人民医院收治的86例老年DR患者,其中52例合并OSAHS(OSAHS组),34例未合并OSAHS(非OSAHS组),比较两组患者的一般生化指标、24 h尿白蛋白水平、胰岛素功能、睡眠相关指标及DR病变程度的分布情况。计量资料的组间比较采用t检验,计数资料的组间比较采用χ^(2)检验。结果OSAHS组患者低密度脂蛋白、餐后2 h血糖、总胆固醇、丙氨酸转氨酶以及尿酸水平均明显高于非OSAHS组(t=2.740、2.129、2.278、2.553、2.141,P<0.05或0.01);24 h尿白蛋白、空腹胰岛素、空腹C肽水平及稳态模型胰岛素抵抗指数均明显高于非OSAHS组(t=5.698、4.594、5.268、7.846,P<0.01);呼吸暂停低通气指数、氧减指数及血氧饱和度低于90%时间占睡眠时间百分比明显高于非OSAHS组(t=22.652、9.817、25.564,P<0.01),而最低血氧饱和度、平均血氧饱和度明显低于非OSAHS组(t=2.040、2.156,P<0.05)。OSAHS组中度和重度非增生DR型的发生率明显高于非OSAHS组(χ^(2)=4.129、4.246,P<0.05)。结论合并OSAHS可能会影响老年DR患者的肝肾功能和糖脂代谢,从而促进中度和重度非增生型DR的发生。Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome(OSAHS)on the progression of type 2 diabetic retinopathy(DR)in elderly patients.Methods A total of 86 elderly patients with DR who were diagnosed in Gucheng People's Hospital during March 2020 and March 2021 were selected.Among them,52 cases were with OSAHS(OSAHS group)and 34 cases were without OSAHS(non-OSAHS group).The general biochemical indexes,24-h urinary albumin,insulin function,sleep related indexes and the progression of DR were analyzed and compared between two groups.T test was used for the comparison between measurement data,and chi-square test was used for the comparison between counting data.Results The results of general biochemical indicators such as low-density lipoprotein,2-hour postprandial blood glucose,total cholesterol,alanine aminotransferase and uric acid levels in OSAHS group were significantly higher than those in non-OSAHS group(t=2.740,2.129,2.278,2.553,2.141;P<0.05 or P<0.01);the levels of 24-hour urinary albumin,fasting insulin,fasting C-peptide and homeostasis model insulin resistance index were significantly higher than those in the non-OSAHS group(t=5.698,4.594,5.268,7.846;P<0.01);apnea and hypopnea index,oxygen desaturation index and percentage of time with SaO2 below 90%in total sleep time were significantly higher than those in non OSAHS group(t=22.652,9.817,25.564;P<0.01),while the lowest and average oxygen saturation levels were significantly lower than those in non-OSAHS group(t=2.040,2.156;P<0.05).Patients in OSAHS group were more likely to have moderate and severe non-proliferative DR(χ^(2)=4.129,4.246;P<0.05).Conclusion OSAHS may affect liver and kidney function,glucose and lipid metabolism in elderly patients with type 2 diabetes,and promote the occurrence of moderate and severe non-proliferative DR.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 2型糖尿病 糖尿病视网膜病变 老年人 

分 类 号：R563.9[医药卫生—呼吸系统] R766[医药卫生—内科学]