CAJ | 학술논문

目的初步分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与糖尿病微血管病变的相关性.方法选取2012年至2013年河南省人民医院内分泌科共239例2型糖尿病(T2DM)患者为研究对象,采用密歇根神经病变筛查表、体感诱发电位与神经传导速度诊断糖尿病周围神经病变(DPN),采用尿白蛋白/肌酐比值诊断糖尿病肾脏病变(DN),采用眼底检查诊断糖尿病视网膜病变(DR),并依次分为DPN组(97例)和非DPN组(142例)、DN组(74例)和非DN组(165例)、DR组(87例)和非DR组(152例),检测患者糖化血红蛋白(HbA1c)及相关生化指标,采用酶联免疫吸附实验(ELISA)测定3-硝基酪氨酸.采用独立t检验、x2检验、logistic回归分析进行统计学处理.结果 Logistic回归分析发现糖尿病病程、HbA1c、OASHS均是DPN患病与否的独立相关因素(OR=1.12、2.93、3.54,P＜0.05),糖尿病程、HbA1c、收缩压、OASHS均是DN患病与否的独立相关因素(OR=1.11、3.23、1.67、9.58,P＜0.05),糖尿病病程、HbA1c、OSAHS是DR患病与否的独立相关因素(OR=1.17、2.89、2.54,P＜0.05).OSAHS组血浆3-硝基酪氨酸高于非OSAHS组[(121.6±9.3)比(87.5 ±9.1) nmol/L,t=4.36,P＜0.05].结论 T2DM患者中OSAHS与糖尿病微血管病变存在独立相关性.
목적 초보분석조새성수면호흡잠정저통기종합정(OSAHS)여당뇨병미혈관병변적상관성.방법 선취2012년지2013년하남성인민의원내분비과공239례2형당뇨병(T2DM)환자위연구대상,채용밀헐근신경병변사사표、체감유발전위여신경전도속도진단당뇨병주위신경병변(DPN),채용뇨백단백/기항비치진단당뇨병신장병변(DN),채용안저검사진단당뇨병시망막병변(DR),병의차분위DPN조(97례)화비DPN조(142례)、DN조(74례)화비DN조(165례)、DR조(87례)화비DR조(152례),검측환자당화혈홍단백(HbA1c)급상관생화지표,채용매련면역흡부실험(ELISA)측정3-초기락안산.채용독립t검험、x2검험、logistic회귀분석진행통계학처리.결과 Logistic회귀분석발현당뇨병병정、HbA1c、OASHS균시DPN환병여부적독립상관인소(OR=1.12、2.93、3.54,P＜0.05),당뇨병정、HbA1c、수축압、OASHS균시DN환병여부적독립상관인소(OR=1.11、3.23、1.67、9.58,P＜0.05),당뇨병병정、HbA1c、OSAHS시DR환병여부적독립상관인소(OR=1.17、2.89、2.54,P＜0.05).OSAHS조혈장3-초기락안산고우비OSAHS조[(121.6±9.3)비(87.5 ±9.1) nmol/L,t=4.36,P＜0.05].결론 T2DM환자중OSAHS여당뇨병미혈관병변존재독립상관성.
Objective To assess the correlation between obstructive sleep apnea-hypopnea syndrome(OSAHS) and diabetic microangiopathy.Methods Total of 239 patients were recruited casually from Department of Endocrinology,Henan Provincial People' s Hospital.Diabetic peripheral neuropathy (DPN) was diagnosed using the Michigan Neuropathy Screening Instrument and neurophysiological methods.Diabetic nephropathy(DN) was diagnosed using urine albumin/creatinine ratio.Diabetic retinopathy(DR) was diagnosed using fundus fluorescein angiography.Patients were divided into DPN group(97) and non-DPN group(142),DN group(74) and non-DN group(165),DR group(87) and non-DR group(152).3-nitrotyrosine (3-NT) was measured by enzyme-lirked immunosorbent assay.The Student t test,Chi-square test and multivariate logistic regression were used.Results Diabetes duration,glycosylated hemoglobin,OSAHS were independent risk factors of DPN (OR =1.12,2.93,3.54,P＜0.05).Diabetes duration,glycosylated hemoglobin,systolic pressure,OSAHS were independent risk factors of DN (OR=1.11,3.23,1.67,9.58,P＜ 0.05).Diabetes duration,glycosylated hemoglobin,OSAHS were independent risk factors of DR (OR=1.17,2.89,2.54,P＜0.05).3-NT levels were higher in patients with OSAHS compared with those without ((121.6± 9.3) vs (87.5 ± 9.1)nmol/L,t=4.36,P＜0.05).Conclusions OSAHS is independently associated with diabetic microangiopathy in type 2 diabetic patients.