论文部分内容阅读
目的:评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并2型糖尿病(T2DM)患者应用经鼻持续呼吸道正压通气(nCPAP)和(或)有氧运动2种不同治疗措施对其睡眠、体质量指数(BMI)、血糖、血脂、血压及其变异系数(CV)的疗效。方法:将96例T2DM患者根据是否合并OSAHS分为单纯T2DM组及OSAHS合并T2DM组,比较2组间各参数的差异。66例OSAHS合并T2DM组的患者根据是否采用nCPAP治疗,分成nCPAP+康复训练组及康复训练组。康复训练组采用低至中等强度的有氧运动,nCPAP+康复训练组在此基础上应用nCPAP治疗,共20周。结果:T2DM组与OSAHS合并T2DM组在年龄、性别、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)及2组的24 h平均舒张压差异无统计学意义(均P>0.05)。OSAHS合并T2DM组的糖代谢、高密度脂蛋白胆固醇(HDL-C)及脂蛋白(a)、血压及昼夜CV较T2DM组差异有统计学意义(均P<0.01)。OSAHS合并T2DM组合并高血压比例高于T2DM组(P=0.002)。经20周的nCPAP和(或)有氧运动后,nCPAP+康复训练组在BMI、呼吸暂停低通气指数(AHI)、血糖、HDL-C、脂蛋白(a)及CV差异有统计学意义(均P<0.05)。nCPAP+康复训练组在AHI、糖代谢指标、HDL-C及脂蛋白(a)、CV与康复训练组比较差异有统计学意义(均P<0.05);2组在BMI、空腹胰岛素(FINS)、总胆固醇、三酰甘油、LDL-C及24 h平均收缩压、24 h平均舒张压差异无统计学意义(均P>0.05)。结论:T2DM与OSAHS密切相关,nCPAP治疗结合个体化的有氧运动对改善T2DM合并OSAHS患者的AHI、BMI、血糖、血脂、胰岛素、血压CV有效。
Objective: To evaluate the effects of nasal continuous positive airway pressure (nCPAP) and / or aerobic exercise on OSAHS with type 2 diabetes mellitus (T2DM) in two groups: sleep apnea syndrome, Body mass index (BMI), blood glucose, blood lipids, blood pressure and coefficient of variation (CV). Methods: Ninety-two patients with T2DM were divided into simple T2DM group and OSAHS combined with T2DM group according to OSAHS. The differences of parameters between the two groups were compared. Sixty-six OSAHS patients with T2DM were divided into nCPAP + rehabilitation group and rehabilitation group according to whether they were treated with nCPAP or not. The rehabilitation training group used low to moderate aerobic exercise. The nCPAP + rehabilitation training group used nCPAP for 20 weeks. Results There were no significant differences in mean diastolic blood pressure at 24h between T2DM group and OSAHS with T2DM group in age, sex, total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C) ). The levels of glucose metabolism, high density lipoprotein cholesterol (HDL-C) and lipoprotein (a), blood pressure and diurnal CV in OSAHS with T2DM were significantly higher than those in T2DM (all P <0.01). OSAHS with T2DM combined with higher proportion of hypertension than T2DM (P = 0.002). There were significant differences in BMI, AHI, blood glucose, HDL-C, lipoprotein (a) and CV after nCPAP and / or aerobic exercise for 20 weeks P <0.05). The levels of BMI, fasting insulin (FINS), fasting insulin (FINS), fasting insulin (FINS) and insulin resistance in nCPAP + rehabilitation training group were significantly different from those in rehabilitation training group (P < Total cholesterol, triglyceride, LDL-C and 24 h average systolic blood pressure, 24 h mean diastolic blood pressure was no significant difference (all P> 0.05). Conclusion: T2DM is closely related to OSAHS. NCPAP combined with individualized aerobic exercise is effective in improving AHI, BMI, blood glucose, blood lipid, insulin and blood pressure CV in T2DM patients with OSAHS.