阻塞性睡眠呼吸暂停综合征患者糖代谢情况分析  

Analysis of glucose metabolism in patients with obstructive sleep apnea syndrome

作　　者：李秀芳[1] 李南方[1] LI Xiufang;LI Nanfang(Hypertension Center,People’s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Hypertension Institute,Key Laboratory of Hypertension Diagnosis and Treatment of National Health Commission,Xinjiang,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院高血压中心、新疆高血压研究所、国家卫生健康委高血压诊疗研究重点实验室,新疆乌鲁木齐830001

出　　处：《中国医药科学》2024年第13期177-181,共5页China Medicine And Pharmacy

基　　金：新疆维吾尔自治区人民医院院内项目(20200407,20230231)。

摘　　要：目的分析男性阻塞性睡眠呼吸暂停综合征(OSAS)患者糖代谢情况,探究OSAS患者糖代谢异常的影响因素。方法连续选取2020年4—12月就诊于新疆维吾尔自治区人民医院高血压诊疗研究中心的男性患者224例,纳入人群均完成多导睡眠呼吸监测、糖耐量-胰岛素释放试验。根据呼吸暂停低通气指数(AHI)分为无OSAS组(59例)、轻度OSAS组(55例)、中度OSAS组(54例)、重度OSAS组(56例)。结果筛查出OSAS患者165例,OSAS组患者血糖异常患病率高于无OSAS组患者,差异有统计学意义(P<0.05)。四组间糖化血红蛋白及各时段血糖水平差异均有统计学意义(P<0.05);重度OSAS组患者糖化血红蛋白水平高于其余各组,差异有统计学意义(P<0.05),重度OSAS组患者空腹、0.5 h、1 h、2 h、3 h血糖水平高于无OSAS组患者,差异有统计学意义(P<0.05),重度OSAS组患者3 h血糖高于轻度OSAS组、2 h血糖高于中度OSAS组,差异有统计学意义(P<0.05)。无、轻度OSAS患者Matsuda指数高于中、重度OSAS患者,HOMA-IR低于中、重度OSAS患者,差异均有统计学意义(P<0.05);无OSAS患者葡萄糖处置指数高于其他各组患者,差异均有统计学意义(P<0.05)。logistic回归发现在校正相关因素后AHI、年龄、颈围和腹围为OSAS患者糖代谢异常的危险因素(P<0.05)。结论本研究结果显示男性OSAS患者合并糖代谢异常的患病率及血糖水平相关参数明显升高,这可能与AHI、年龄、颈围及腹围等危险因素有关。Objective To analyze the glucose metabolism in male patients with obstructive sleep apnea syndrome(OSAS)and explore the influencing factors of abnormal glucose metabolism in OSAS patients.Methods 224 male patients admitted to the Hypertension Center of the People’s Hospital of Xinjiang Uygur Autonomous Region from April to December,2020 were selected continuously and completed polysomnography and glucose tolerance-insulin release test.According to the apnea hypopnea index(AHI),they were divided into the non-OSAS group(59 patients),the mild OSAS group(55 patients),the moderate OSAS group(54 patients)and the severe OSAS group(56 patients).Results 165 patients with OSAS were screened out.The prevalence of abnormal blood sugar in OSAS group was higher than that in non-OSAS group,with statistically significant difference(P<0.05).There were significant differences in glycosylated hemoglobin and blood sugar levels in each period between the four groups(P<0.05).The level of glycosylated hemoglobin in the severe OSAS group was higher than that in other groups,with statistically significant difference(P<0.05).The blood glucose levels at fasting state,0.5h,1h,2h and 3h in the severe OSAS group were higher than those in the non-OSAS group,with statistically significant differences(P<0.05).The blood glucose level at 3h in the severe OSAS group was higher than that in the mild OSAS group and the blood glucose level at 2h in the moderate OSAS group,with statistical significance difference(P<0.05).The Matsuda index in the non-OSAS and mild OSAS groups was higher than that in the moderate and severe OSAS groups,and HOMA-IR in them was lower than that in the moderate and severe OSAS groups,with statistical significance differences(P<0.05).The glucose disposal index in the non-OSAS group was higher than that in other groups,with statistically significant difference(P<0.05).logistic regression showed that AHI,age,neck circumference and abdominal circumference were risk factors for abnormal glucose metabolism in OSAS patients after

关 键 词：阻塞性睡眠呼吸暂停综合征 糖代谢 危险因素 患病率 

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