中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2014年
10期
737-741
,共5页
李晨光%陈莉明%倪长霖%常宝成%李竹%杨敏%汤云昭%姜振环%朱艳娟
李晨光%陳莉明%倪長霖%常寶成%李竹%楊敏%湯雲昭%薑振環%硃豔娟
리신광%진리명%예장림%상보성%리죽%양민%탕운소%강진배%주염연
睡眠呼吸暂停,阻塞性%糖尿病,2型%炎症因子
睡眠呼吸暫停,阻塞性%糖尿病,2型%炎癥因子
수면호흡잠정,조새성%당뇨병,2형%염증인자
Sleep apnea,obstructive%Diabetes mellitus,type 2%Inflammatory factor
目的 观察持续正压通气(CPAP)对2型糖尿病(T2DM)伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者炎症和胰岛素抵抗的影响.方法 选择2012年1月至2014年1月诊断为T2DM伴OSAHS的患者74例,按随机数字表法分为干预组和对照组各37例.其中男51例,女23例,年龄45～ 66岁.干预组接受14d的CPAP治疗.检测治疗前后空腹血糖(FBG)、果糖胺(FMN)、空腹胰岛素(FINS)、白细胞(WBC)计数、超敏C反应蛋白(hs-CRP)、缺氧诱导因子1α(HIF-1α)和可溶性血管内皮细胞黏附因子-1 (sVCAM-1).以稳态模型分析法(HOMA)评估稳态模型的胰岛素抵抗指数(HOMA-IR),多导睡眠图(PSG)监测治疗前后平均血氧饱和度(MSpO2)、最低血氧饱和度(LSpO2)、睡眠呼吸暂停指数(AHI).采用t检验、卡方检验、Spearman相关分析进行数据统计.结果 干预组FBG、FMN、FINS、MSpO2、LSpO2、AHI均有不同程度的改善(￡=-123.761～120.676,均P＜0.05),hs-CRP、HIF-1α、sVCAM-1、HOMA-IR治疗后较治疗前均显著下降[(2.4±0.4)比(7.3±0.3)mg/L、(211±6)比(275±53)ng/L、(589±57)比(717±73) ng/L,2.1±0.7比3.7-±0.2,t=-53.046、-19.827、-12.827、-28.342,均P＜0.05].Pearson相关分析示干预组治疗后HOMA-IR改善程度与HIF-1α、sVCAM-1改善程度呈正相关(r=0.87、0.86,均P＜0.05).结论 CPAP可改善T2DM伴OSAHS患者炎症状态,提高睡眠质量,改善胰岛素抵抗.
目的 觀察持續正壓通氣(CPAP)對2型糖尿病(T2DM)伴阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者炎癥和胰島素牴抗的影響.方法 選擇2012年1月至2014年1月診斷為T2DM伴OSAHS的患者74例,按隨機數字錶法分為榦預組和對照組各37例.其中男51例,女23例,年齡45～ 66歲.榦預組接受14d的CPAP治療.檢測治療前後空腹血糖(FBG)、果糖胺(FMN)、空腹胰島素(FINS)、白細胞(WBC)計數、超敏C反應蛋白(hs-CRP)、缺氧誘導因子1α(HIF-1α)和可溶性血管內皮細胞黏附因子-1 (sVCAM-1).以穩態模型分析法(HOMA)評估穩態模型的胰島素牴抗指數(HOMA-IR),多導睡眠圖(PSG)鑑測治療前後平均血氧飽和度(MSpO2)、最低血氧飽和度(LSpO2)、睡眠呼吸暫停指數(AHI).採用t檢驗、卡方檢驗、Spearman相關分析進行數據統計.結果 榦預組FBG、FMN、FINS、MSpO2、LSpO2、AHI均有不同程度的改善(￡=-123.761～120.676,均P＜0.05),hs-CRP、HIF-1α、sVCAM-1、HOMA-IR治療後較治療前均顯著下降[(2.4±0.4)比(7.3±0.3)mg/L、(211±6)比(275±53)ng/L、(589±57)比(717±73) ng/L,2.1±0.7比3.7-±0.2,t=-53.046、-19.827、-12.827、-28.342,均P＜0.05].Pearson相關分析示榦預組治療後HOMA-IR改善程度與HIF-1α、sVCAM-1改善程度呈正相關(r=0.87、0.86,均P＜0.05).結論 CPAP可改善T2DM伴OSAHS患者炎癥狀態,提高睡眠質量,改善胰島素牴抗.
목적 관찰지속정압통기(CPAP)대2형당뇨병(T2DM)반조새성수면호흡잠정저통기종합정(OSAHS)환자염증화이도소저항적영향.방법 선택2012년1월지2014년1월진단위T2DM반OSAHS적환자74례,안수궤수자표법분위간예조화대조조각37례.기중남51례,녀23례,년령45～ 66세.간예조접수14d적CPAP치료.검측치료전후공복혈당(FBG)、과당알(FMN)、공복이도소(FINS)、백세포(WBC)계수、초민C반응단백(hs-CRP)、결양유도인자1α(HIF-1α)화가용성혈관내피세포점부인자-1 (sVCAM-1).이은태모형분석법(HOMA)평고은태모형적이도소저항지수(HOMA-IR),다도수면도(PSG)감측치료전후평균혈양포화도(MSpO2)、최저혈양포화도(LSpO2)、수면호흡잠정지수(AHI).채용t검험、잡방검험、Spearman상관분석진행수거통계.결과 간예조FBG、FMN、FINS、MSpO2、LSpO2、AHI균유불동정도적개선(￡=-123.761～120.676,균P＜0.05),hs-CRP、HIF-1α、sVCAM-1、HOMA-IR치료후교치료전균현저하강[(2.4±0.4)비(7.3±0.3)mg/L、(211±6)비(275±53)ng/L、(589±57)비(717±73) ng/L,2.1±0.7비3.7-±0.2,t=-53.046、-19.827、-12.827、-28.342,균P＜0.05].Pearson상관분석시간예조치료후HOMA-IR개선정도여HIF-1α、sVCAM-1개선정도정정상관(r=0.87、0.86,균P＜0.05).결론 CPAP가개선T2DM반OSAHS환자염증상태,제고수면질량,개선이도소저항.
Objective To observe the effects of continuous positive airway pressure(CPAP) treatment on inflammation and insulin resistance in patients with type 2 diabetes mellitus(T2DM) and obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Seventy-four patients (51 males and 23 females,with an age range of 45-66 years old) diagnosed as T2DM and OSAHS syndrome from January 2012 to January 2014 were randomly and equally divided into the treatment group(n=37) and the control group(n=37).Patients in the treatment group were treated with CPAP for 14 days.The fasting blood glucose (FBG),fructosamine (FMN),fasting insulin (FINS),white blood cell (WBC)count,high sensitive C reactive protein (hs-CRP),hypoxia inducible factor-1α (HIF-1α) and soluble vascular cell adhesion molecule-1(sVCAM-1) was detected before and after treatment.The homeostasis model assessment (HOMA) insulin resistance (HOMA-IR) index,the mean pulse oxygen saturation (MSpO2),the lowest pulse oxygen saturation (LSpO2) and apnea hypopnea index (AHI) were monitored by polysomnography (PSG) before and after treatment.T test,x2 test and Spearman correlation analysis were used to evaluate the data.Results Compared to the control group,the level of FBG,FMN,FINS,MSpO2,LSpO2,AHI was improved in the treatment group by a certain degree after treatment (t =-123.761-120.676,all P＜0.05).The level of hs-CRP,HIF-1α,sVCAM-1 and HOMA-IR was significantly reduced from (7.3±0.3)mg/L,(275±53) ng/L,(717±73) ng/L and 3.7±0.2 before treatment to (2.4±0.4) mg/L,(21 1±6) ng/L,(589±57) ng/L and 2.1±0.7 after treatment,respectively (t=-53.046,-19.827,-12.827,-28.342,respectively,all P＜0.05).The improvements showed by Pearson analysis in HOMA-IR after treatment were positively correlated with HIF-1α and sVCAM-1 improvements r=0.87,0.86,both P＜0.05).Conclusion CPAP may improves the inflammation status,sleep quality,insulin resistance in patients with T2DM and OSAHS.
