阻塞性睡眠呼吸暂停低通气综合征患者血清代谢指标分析及其临床意义

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清代谢指标的改变及其临床意义。方法：对95例疑似OSAHS患者进行PSG检查，根据PSG结果将患者分为OsAHS组65例和非OSAHS组（对照组）30例。对所有患者抽取静脉血进行生化指标检测，记录尿素氮（BUN）、肌酐（Cr）、尿酸（UA）、空腹血糖（FG）、总胆固醇（Tc）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）等代谢指标。根据AHI、LSaO2将患者进一步分为轻中度OsAHS组和重度0sAHS组、轻中度低氧组和重度低氧组，比较分析0sAHS组和对照组之间以及不同程度0sAHs组间上述代谢指标的差异。结果：OSAHs组血清Cr、UA、TG的含量明显高于对照组，HDL—C的含量明显低于对照组（P〈0．01或P〈0．05），而BUN、FG、TC、LDL—C的血清含量在两组间的差异无统计学意义（P〉0．05）。轻中度OSAHS组患者血清TG含量明显低于重度0sAHS组（P〈0．01），其他各项指标的差异均无统计学意义（P〉0．05）；轻中度低氧组血清BUN、UA和TG含量明显低于重度低氧组，HDL-C含量明显高于重度低氧组（P〈0．01或P〈0．05）；两组患者血清Cr、FG、TC和LDL—C含量则无显著性差异（P〉0．05）。结论：OSAHS对患者的代谢指标能够产生较大影响，引起代谢指标改变的主要因素是OSAHS所致的低氧血症和高碳酸血症。AHI值的高低不能很好地反映OSAHS患者的低氧程度，对代谢指标的影响较小，临床上应结合LSaO2对OSAHS患者的严重程度进行综合评判。

Analysis of serum metabolic index in patients with OSAHS and its clinical significance

Objective： To investigate the changes of serum metabolic indices and to analyze its clinical significance in patients with OSAHS. Method： Ninety-five patients with suspected OSAHS were underwent the monitoring of popolysomnogram （PSG）. According to the results of PSG, 65 cases fell into OSAHS group and the other 30 cases non OSAHS group （i. e. control group）. Biochemical indexes of venous blood were detected and recorded for all patients which include urea nitrogen （BUN）, creatinine （Cr）, uric acid （UA）, fasting blood glucose （FG）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol （LDL-C）. The patients in OSAHS group were further divided into mild to moderate OSAHS group and severe OSAHS group based on apnea hyponea index （AHI） results, and then divided into mild to moderate hypoxia group and severe hypoxia group based on the LSaO2 results, respectively. We compared and analysed the differences of metabolic indices between OSAHS group and control group and those between OSAHS groups in varying degree. Result： Level of serum Cr, UA, TG in OSAHS group was significantly higher than those in control group（P〈0.01）. The level of HDL-C in OSAHS group were significantly lower than that in the control group （P〈0.05）. While there was no significant difference in serum content of BUN, FG, TC, LDL-C between these two group （P〉0.05）. Serum TG content in mild to moderate OSAHS group was significantly lower than that in severe group （P〈0.01）; differences of other indexes were not significant between these two groups （P〉0.05）. Serum BUN, UA and TG in mild to moderate hypoxia group were significantly lower than that in severe hypoxia group; HDL-C in mild to moderate hypoxia group was significantly higher than those in severe hypoxia group （P〈0.01 or P〈0.05） ; there was no significant difference of serum Cr, FG, TC and LDL-C content between theses two groups （P〉0.05）. Conclusion..OSAHS significantly affects the metabolic indices and its reason predominantly comes from the hypoxemia and hypercapnia. AHI value can not very well reflect the degree of hypoxia in patients with OSAHS, so it has little effect on the metabolism. The comprehensive evaluation of severity of OSAHS should combine it with the lowest oxygen saturation.