合并OSAHS的老年急性脑梗死患者同型半胱氨酸和胰岛素抵抗临床分析

目的研究合并阻塞性睡眠呼吸暂停综合征(OSAHS)的老年急性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)及稳态模型胰岛素抵抗指数(HOMA-IR)水平,分析老年ACI患者OSAHS、Hcy和HOMA-IR相互关系。方法根据年龄和睡眠呼吸监测数据,将患者分为老年ACI+OSAHS组(n=21)、老年ACI组(n=30)、中年ACI+OSAHS组(n=28)和中年ACI组(n=34),检测并比较各组血清Hcy、胰岛素抵抗指数(HOMA-IR)等各指标。结果老年ACI+OSAHS组较其余3组的Hcy和HOMA-IR均升高,差异有统计学意义(P0.05);中年ACI+OSAHS组较中年ACI组Hcy和HOMA-IR增高,差异有统计学意义(P0.05)。Hcy与年龄、AHI、平均腰围、BMI、HOMAIR均呈正相关;多元线性回归分析显示AHI与年龄、Hcy、HOMA-IR、BMI呈正相关。结论随年龄的增加,合并OSAHS的急性脑梗死患者Hcy和HOMA-IR水平随之升高;OSAHS可能通过升高Hcy及增加胰岛素抵抗导致ACI。

The clinical analysis of homocysteine and insulin resistance in acute cerebral infarction elderly patients with obstr-active sleep apnea-hypopnea syndrome

Objective To investigate the levels of homocysteine (Hcy) and insulin resistance in acute cerebral in-farction (ACI) elderly patients with obstractive sleep apnea syndrome (OSAHS),and analysis the relationships of them . Methods The participants were divided into the elderly ACI ﹢OSAHS group (n=21),elderly ACI group (n=30),mid-dle-aged ACI﹢OSAHS group (n=28) and middle-aged ACI group (n=34) according to the age and results of polysom-nography.The serum Hcy and insulin resistance(HOMA-IR) were detected,then analysis the relationship of OSAHS,Hcy and HOMA-IR.Results The Hcy and HOMA-IR levels in elderly ACI﹢OSAS group were higher than this in other groups (P<0.05);the Hcy and HOMA-IR levels in middle-aged ACI﹢OSAS group were higher than this in middle-aged ACI groups (P<0.05);the Hcy levels were positively correlated with the age ,AHI,waist circumference,BMI and HOMA-IR levels;and the AHI were positively correlated with the age ,Hcy,HOMA-IR levels and BMI.Conclusion The Hcy and HO-MA-IR levels increased with the advancing age in ACI elderly patients with OSAHS;OSAHS may affect the Hcy and insulin resistance levels ,then causes ACI .