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目的:探讨经鼻持续气道正压通气(CPAP)对睡眠呼吸暂停低通气综合征(OSAHS)合并2型糖尿病患者的疗效观察。方法:将76例2型糖尿病合并OSAHS患者分为两组,每组38例。对照组采用常规的降糖治疗;观察组在对照组治疗基础上给予CPAP治疗。对比两组治疗前后睡眠治疗及血糖代谢的变化。结果:观察组治疗后睡眠评价量表(ESS)评分、呼吸暂停低通气指数(AHI)显著降低,且显著低于对照组治疗后,最低血氧饱和度(mini Sa O2)、平均血氧饱和度(mean Sa O2)水平显著升高,且显著高于对照组治疗后;对照组治疗前后ESS评分、AHI、mini Sa O2、mean Sa O2水平无显著性改变;两组治疗前后空腹血糖(FPG)无显著性改变;观察组治疗后人工气道压力滴定试验(OGTT)-1h、OGTT-2h的血糖水平及胰岛素敏感指数(ISI)显著降低,且显著低于对照组治疗后,差异有统计学意义。结论:CPAP能显著改善2型糖尿病合并OSAHS患者睡眠呼吸调节功能,减轻胰岛素抵抗,提高患者血糖代谢功能。
Objective: To investigate the efficacy of nasal continuous positive airway pressure (CPAP) in patients with sleep apnea-hypopnea syndrome (OSAHS) complicated with type 2 diabetes mellitus. Methods: 76 type 2 diabetic patients with OSAHS were divided into two groups, 38 cases in each group. The control group used routine hypoglycemic treatment; the observation group was given CPAP treatment on the basis of the control group. The changes of sleep treatment and blood glucose metabolism before and after treatment were compared between the two groups. Results: The scores of sleep evaluation scale (ESS) and apnea-hypopnea index (AHI) in the observation group were significantly lower than those in the control group after treatment, the minimum oxygen saturation (mini Sa O2), average oxygen saturation Mean Sa O2 level was significantly higher than that of the control group after treatment; the ESS score, AHI, mini Sa O2 and mean Sa O2 levels in the control group before and after treatment had no significant change; before and after treatment, fasting blood glucose (FPG ). There was no significant change in the observation group after treatment of artificial airway pressure titration test (OGTT) -1h, OGTT-2h blood glucose levels and insulin sensitivity index (ISI) significantly decreased, and significantly lower than the control group after treatment, the difference was statistically Significance of learning. Conclusion: CPAP can significantly improve sleep-respiratory regulation, reduce insulin resistance and improve blood glucose metabolism in patients with type 2 diabetes mellitus and OSAHS.