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伴有阻塞性睡眠呼吸暂停低通气综合征的糖尿病患者的临床特点分析

来自:中国糖尿病资讯网  编辑:editor|点击数:|2012-09-24

  【摘要】 目的 探讨伴有阻塞性睡眠低通气呼吸暂停综合征(OSAHS)的糖尿病患者的临床特点,以提高糖尿病与OSAHS关系的认识。 方法 对2007年 1月到2009年12月期间资料完整的130例糖尿病患者进行多导睡眠监测。根据睡眠呼吸暂停低通气指数(AHI)将糖尿病患者分为OSAHS组和非OSAHS组。收集所有患者的一般资料,检测血脂、糖代谢等指标并计算胰岛素抵抗指数(HOMA-IR),比较两组参数的差异。 结果 OSAHS组BMI、AHI、最低脉搏容积血氧饱和度(LSpO2)、血清TG、HbA1c、FIns、HOMA-IR等参数均高于非OSAHS组(P均<0.05)。OSAHS组血清FIns及HOMA-IR与AHI呈正相关(r=0.203,P<0.05;r=0.327,P<0.05),与LSpO2呈负相关(r=-0.291,P<0.05;r=-0.637,P<0.01)。OSAHS组高血压和冠心病并发症明显高于非OSAHS组(P<0.05)。 结论 伴有OSAHS的糖尿病患者由于慢性间歇性低氧与IR相关,故发生高血压、冠心病的可能性增大,医务工作者应提高糖尿病患者OSAHS的识别。

  【关键词】 睡眠呼吸暂停,阻塞性;糖尿病;血脂;血糖

  Analysis on the clinical features of diabetes mellitus patients complicated with obstructive sleep apnea-hypopnea syndrome LI Yu, CHEN Chen, DING Shao-fang, et al. Department of Internal Medicine, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China

  Corresponding author: DING Shao-fang, E-mail: dsf1956@126.com

  【Abstract】 Objective To analyze the clinical features of diabetes mellitus (DM) patients complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS) for better understanding the relationship of DM with OSAHS. Methods Those 130 DM patients with complete clinical data were divided into two groups according to their apnea-hypopnea indices (AHI): DM with OSAHS (n=67) and DM without OSAHS (n=63). General conditions, lipid profiles and glycemic control parameters were detected and compared. And then, an analysis on the relation of sleep monitoring indices and IR was performed in the OSAHS group. Results The BMI, AHI, LSpO2, TG, HbA1c, FIns, and HOMA-IR in the OSAHS group were significantly higher than those in the without OSAHS group (P<0.05). The serum FIns and HOMA-IR were positively related with AHI (r=0.203, P<0.05; r=0.327, P<0.05 ) and negatively with LSpO2 (r=-0.291, P<0.05; r=-0.637, P<0.01) in the OSAHS group. And the complications of hypertension and coronary heart disease (CHD) in the OSAHS group were significantly higher than those in the without OSAHS group (P<0.05). Conclusion Because the chronic intermittent hypoxemia is related with IR, the possibility of incidence of hypertension and CHD is increased in the DM patients with OSAHS. Doctors should pay more attention to OSAHS in DM patients.

  【Key words】 Sleep apnea, obstructive; Diabetes mellitus; Dyslipidemia; Blood glucose

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