气道正压通气对中重度阻塞性睡眠呼吸暂停低通气综合征患者胰岛素抵抗的影响

目的：探讨中重度阻塞型睡眠呼吸暂停低通气综合征（OSAHS）与胰岛素抵抗之间的关系,以及持续正压通气（CPAP）治疗OSAHS对胰岛素抵抗的影响。方法：分析58例中重度OSAHS患者CPAP治疗前后及20例未治疗中重度OSAHS患者多导睡眠监测指标与空腹血糖、胰岛素和餐后2h血糖、胰岛素的关系,另选择45例不符合OS-AHS诊断的健康者为对照组。结果：OSAHS组治疗前,餐后血糖、餐后胰岛素明显高于对照组（P〈0.01）,胰岛素敏感指数明显低于对照组（P〈0.01）。CPAP治疗30d,餐后血糖、胰岛素较前显著下降（P〈0.01）,胰岛素敏感指数明显增高（P〈0.01）。结论：OSAHS组治疗前,血糖和血浆胰岛素比对照组高,治疗后OSAHS组比未治疗组低。表明OSAHS可产生胰岛素抵抗,而CPAP治疗可以改善胰岛素抵抗。

Effect of continuous positive airway pressure on insulin resistance in patients with obstructive sleep apnea hypopnea syndrome

Objective:To investigate the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)hypoxemia and insulin resistance(IR),and the effectiveness of continuous positive airway pressure(CPAP)to OSAHS and IR.Methods:58 patients with moderate to severe OSAHS were treated by CPAP.All index of the nocturnal polysomnography,insulin and blood sugar in empty stomach,insulin and blood sugar 2 hours after meal were analysed before and after treatment,and in 20 patients with moderate to severe OSAHS with NIDDM untreated with CPAP.The other 45 normal subjects were treated as control group.Results:In OSAHS group,before treatment blood sugar after meal,insulin after meal were higher than in control group,insulin sensitivity were lower.30 days after treatmrnt,the levels of blood sugar and insulin in OSAHS group are lower than those in OSAHS group untreated with CPAP.Conclusion:OSAHS may improve insulin resistance and CPAP can increase insulin resistance.