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目的:研究西宁地区2型糖尿病与阻塞性睡眠呼吸暂停综合征的相关性。方法:以2011年3月—2015年12月我院收治的100例2型糖尿病合并阻塞性睡眠呼吸暂停综合征患者为观察组,选取同期体检健康的100例为对照组,对所有对象进行血生化检查、采用多导睡眠监测仪测定患者的相关呼吸指数,并采用体内稳态模式评估指数评价胰岛素抵抗的指标,以说明西宁地区2型糖尿病与阻塞性睡眠呼吸暂停综合征的相关性。结果:观察组的空腹血糖、餐后2h血糖及空腹胰岛素C-肽指标的水平均高于对照组,差异显著(P<0.05)。而随着阻塞性睡眠呼吸暂停综合征患病程度的升高,观察组患者的体内稳态模式评估指数(HOMA-IR)显著降低。呼吸参数对比发现,观察组呼吸暂停/低通气指数(AHI)均高于对照组,最低脉搏容积血氧饱和度(LSpO2)均低于对照组,而随着阻塞性睡眠呼吸暂停综合征患病程度的升高,观察组患者的AHI显著升高。回归分析发现HOMA-IR、血糖(餐后2h)与阻塞性睡眠呼吸暂停综合征患病程度呈正相关,是该地区2型糖尿病合并阻塞性睡眠呼吸暂停综合征患者患病程度的独立危险因素。结论:阻塞性睡眠呼吸暂停综合征能诱发糖代谢异常,而西宁地区由于缺氧,更能引起和加速2型糖尿病的病发及发展,与此同时,应当积极治疗阻塞性睡眠呼吸暂停综合征,以促进2型糖尿病患者的康复。
Objective: To investigate the relationship between type 2 diabetes and obstructive sleep apnea syndrome in Xining area. Methods: From March 2011 to December 2015, 100 patients with type 2 diabetes mellitus and obstructive sleep apnea syndrome treated in our hospital were selected as the observation group. 100 healthy people in the same period were selected as the control group, and blood was collected from all subjects Biochemical tests, polysomnography was used to measure the relative respiratory index of patients, and the index of in vivo steady-state assessment of insulin resistance was used to evaluate the relationship between type 2 diabetes and obstructive sleep apnea syndrome in Xining. Results: The levels of fasting blood glucose, 2h postprandial blood glucose and fasting insulin C-peptide in observation group were significantly higher than those in control group (P <0.05). With the increased prevalence of obstructive sleep apnea syndrome, the patients in the observation group had significantly lower HOMA-IR scores. Comparison of respiratory parameters found that the observation group, apnea / hypopnea index (AHI) were higher than the control group, the lowest pulse volume oxygen saturation (LSpO2) were lower than the control group, and with obstructive sleep apnea syndrome The level of AHI was significantly higher in the observation group. Regression analysis found that HOMA-IR, blood glucose (2h postprandial) was positively correlated with the severity of obstructive sleep apnea syndrome, which was an independent risk factor for type 2 diabetes in patients with obstructive sleep apnea syndrome. Conclusion: Obstructive sleep apnea syndrome can induce abnormal glucose metabolism, but due to hypoxia in Xining, it can cause and accelerate the onset and development of type 2 diabetes mellitus. At the same time, active treatment of obstructive sleep apnea syndrome , To promote the recovery of type 2 diabetic patients.