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目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生胰岛素抵抗与糖耐量受损的原因。方法选择OSAHA患者53例为观察组,选择同期非OSAHS患者70例为对照组。将观察组患者根据睡眠呼吸暂停低通气指数(AHI)和最低脉搏氧合度(PSO2)分为轻度组(15例),中度组(17例)和重度组(21例)。测定并比较不同组研究对象的常规代谢指标及脂代谢指标。结果重度OSAHS患者BMI、空腹和餐后2h血糖水平、糖化血红蛋白水平、胰岛素抵抗指数水平高于对照组(P<0.05),而空腹和餐后2 h的胰岛素水平低于对照组(P<0.05)。轻度、中度、重度OSAHS患者的总胆固醇、三酰甘油、高低密度脂蛋白胆固醇水平与对照组比较,差异未见统计学意义(P>0.05)。结论 OSAHS患者存在不同程度的夜间缺氧症状,从而引起糖耐量受损和胰岛素抵抗,其与2型糖尿病的发生和发展密切相关。
Objective To investigate the causes of impaired insulin resistance and impaired glucose tolerance in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Fifty-three patients with OSAHA were selected as the observation group and 70 patients with non-OSAHS during the same period were selected as the control group. Patients in the observation group were divided into mild group (15 cases), moderate group (17 cases) and severe group (21 cases) according to sleep apnea-hypopnea index (AHI) and minimum pulse oxygenation index (PSO2) Determination and comparison of different groups of conventional metabolic parameters and lipid metabolism indicators. Results The serum levels of BMI, fasting and 2h postprandial blood glucose, glycosylated hemoglobin and insulin resistance were significantly higher in patients with severe OSAHS (P <0.05), while those in fasting and postprandial 2h were lower than those in control group (P <0.05 ). The levels of total cholesterol, triglyceride and high and low density lipoprotein cholesterol in mild, moderate and severe OSAHS patients were not significantly different from those in control group (P> 0.05). Conclusion OSAHS patients have different degrees of nocturnal hypoxia symptoms, which lead to impaired glucose tolerance and insulin resistance, which is closely related to the occurrence and development of type 2 diabetes mellitus.