中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2011年
9期
738-742
,共5页
睡眠呼吸暂停,阻塞性%葡萄糖代谢障碍%持续气道正压通气
睡眠呼吸暫停,阻塞性%葡萄糖代謝障礙%持續氣道正壓通氣
수면호흡잠정,조새성%포도당대사장애%지속기도정압통기
Sleep apnea,obstructive%Glucose metabolism disorders%Continuous positive airway pressure
目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者糖代谢异常的发生情况及与OSAHS严重程度的关系;短期持续气道正压(CPAP)通气治疗后,糖代谢异常是否会有所改善.方法 监测214例OSAHS者的睡眠和糖代谢,对糖代谢异常者行CPAP通气治疗.结果 糖代谢异常者OSAHS组88例(54.3%),对照组17例(32.7%).Logistic回归分析显示,糖代谢异常与OSAHS相关.OSAHS患者[呼吸暂停低通气指数(AHI)≥10次/h]发生糖代谢异常的风险是普通人群的2.44倍(95%CI 1.201～4.958).7例患者行CPAP通气治疗,治疗前后血糖变化差异无统计学意义(P＞0.05).结论 OSAHS患者(AHI≥10次/h)糖代谢异常的发生率高,OSAHS是糖代谢异常的独立危险因素之一;超重和(或)肥胖在糖代谢异常的发生、发展中起主要作用,排除超重和(或)肥胖的干扰,OSAHS患者的血糖水平与AHI、最长呼吸暂停时间相关;短期CPAP通气治疗改善OSAHS患者糖代谢异常的效果不明显.
目的 探討阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者糖代謝異常的髮生情況及與OSAHS嚴重程度的關繫;短期持續氣道正壓(CPAP)通氣治療後,糖代謝異常是否會有所改善.方法 鑑測214例OSAHS者的睡眠和糖代謝,對糖代謝異常者行CPAP通氣治療.結果 糖代謝異常者OSAHS組88例(54.3%),對照組17例(32.7%).Logistic迴歸分析顯示,糖代謝異常與OSAHS相關.OSAHS患者[呼吸暫停低通氣指數(AHI)≥10次/h]髮生糖代謝異常的風險是普通人群的2.44倍(95%CI 1.201～4.958).7例患者行CPAP通氣治療,治療前後血糖變化差異無統計學意義(P＞0.05).結論 OSAHS患者(AHI≥10次/h)糖代謝異常的髮生率高,OSAHS是糖代謝異常的獨立危險因素之一;超重和(或)肥胖在糖代謝異常的髮生、髮展中起主要作用,排除超重和(或)肥胖的榦擾,OSAHS患者的血糖水平與AHI、最長呼吸暫停時間相關;短期CPAP通氣治療改善OSAHS患者糖代謝異常的效果不明顯.
목적 탐토조새성수면호흡잠정저통기종합정(OSAHS)환자당대사이상적발생정황급여OSAHS엄중정도적관계;단기지속기도정압(CPAP)통기치료후,당대사이상시부회유소개선.방법 감측214례OSAHS자적수면화당대사,대당대사이상자행CPAP통기치료.결과 당대사이상자OSAHS조88례(54.3%),대조조17례(32.7%).Logistic회귀분석현시,당대사이상여OSAHS상관.OSAHS환자[호흡잠정저통기지수(AHI)≥10차/h]발생당대사이상적풍험시보통인군적2.44배(95%CI 1.201～4.958).7례환자행CPAP통기치료,치료전후혈당변화차이무통계학의의(P＞0.05).결론 OSAHS환자(AHI≥10차/h)당대사이상적발생솔고,OSAHS시당대사이상적독립위험인소지일;초중화(혹)비반재당대사이상적발생、발전중기주요작용,배제초중화(혹)비반적간우,OSAHS환자적혈당수평여AHI、최장호흡잠정시간상관;단기CPAP통기치료개선OSAHS환자당대사이상적효과불명현.
Objective To investigate the prevalence of impaired glucose-insulin metabolism in obstructive sleep apnea hypopnea syndrome (OSAHS); to examine the relation between severity of OSAHS and impaired glucose metabolism; and to evaluate the effectiveness of continuous positive airway pressure (CPAP) on impaired glucose metabolism.Methods A total of 214 patients who were free of diabetes at baseline underwent both nocturnal polysomnography (PSG),and 2-h oral glucose-tolerance test,insulin and hemoglobin Alc test.CPAP treatment for glucose-insulin metabolism ( + ) was given to OSAHS group after informed consent had been obtained.Results Eighty-eight patients and 17 patients with impaired glucoseinsulin metabolism were found in OSAHS group and the control group respectively.Impaired glucose-insulin metabolism was present in 54.3% of OSAHS group and 32.7% of control group.Logistic regression analysis showed a significant positive correlation with OSAHS ( AHI ≥ 10 times/h ) and impaired glucose-insulin metabolism in all patients (OR = 2.440,95% CI 1.201-4.958 ).Plasma glucose level changes had no significant differences between before and after CPAP treatment (P ＞ 0.05 ).ConclusionOSAHS is associated with a high frequency of impaired glucose metabolism.The relationship between OSAHS and impaired glucose metabolism is independent of obesity.Longest apnea time (LAT) and AHI are important contributors to impaired glucose metabolism in OSAHS patients.Short-term CPAP therapy has no significant improvement on glucose metabolism in patients with OSAHS.
