血清胰岛素样生长因子-1及胰淀素在阻塞性睡眠呼吸暂停低通气综合征合并2型糖尿病患者中的变化及意义

发布时间：2018-03-06 04:06

本文选题：睡眠呼吸暂停低通气综合征　切入点：2型糖尿病　出处：《山西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：1.观察阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopneasyndrome,OSAHS）及OSAHS合并2型糖尿病（T2DM）患者血清胰岛素样生长因子-1 (IGF-1)、胰淀素（Amylin）水平的变化，并探讨它们在OSAHS相关T2DM发病中的作用； 2.观察并讨论经鼻持续气道内正压通气（nasal-continuous positive airwaypressure,nCPAP）呼吸机治疗对OSAHS合并T2DM患者血清IGF-1、Amylin水平的影响。方法：1.所有受试对象均进行多导睡眠图监测（polysomnography, PSG），并根据OSAHS和T2DM的诊断标准将受试对象分为单纯OSAHS组（简称O组）28例，，OSAHS合并T2DM组（简称OD组）28例，单纯T2DM组（简称DM组）28例，另选正常对照组（简称N组）28例。用酶联免疫吸附法测所有入选者血清IGF-1、Amylin水平。 2.OD组中选取20例依从性较好的患者，经nCPAP治疗1月后，复查PSG、空腹血糖（FPG），再次检测血清IGF-1、Amylin浓度，观察其变化。结果：1.O组、DM组及OD组血清IGF-1水平均较N组降低（P0.01），OD组水平最低，O组、DM组及OD组三组间血清IGF-1水平有显著性差异（P0.01）；O组、DM组及OD组血清Amylin水平均较N组升高（P0.01），OD组水平最高，O组、DM组及OD组三组间血清Amylin水平亦有显著性差异（P0.01）。 2.经nCPAP治疗后OD组患者血清IGF-1水平较治疗前升高(P0.01)；Amylin水平较治疗前降低(P0.01)。 3.血清IGF-1水平与AHI呈负相关（P0.01），与LSaO2及MSaO2呈正相关（P0.01）；血清Amylin水平与AHI呈正相关（P0.01），与LSaO2及MSaO2呈负相关（P0.01）。结论：1.间歇缺氧是引起血清IGF-1水平降低、Amylin水平升高的危险因素之一； 2.IGF-1、Amylin可作为OSAHS患者血糖升高的预测因子； 3.nCPAP治疗可改善OSAHS合并T2DM患者血清IGF-1、胰淀素、血糖水平，延缓OSAHS所致2型糖尿病的发生发展。
[Abstract]:Objective 1. To observe the changes of serum insulin-like growth factor-1 (IGF-1) and amylin (amylin) levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and OSAHS with type 2 diabetes mellitus (T2DM), and to explore their role in the pathogenesis of T2DM. 2. To observe and discuss the effect of nasal-continuous positive airway pressure pressure (CPAP) ventilator therapy on serum IGF-1Amylin level in patients with OSAHS complicated with T2DM. Methods: all subjects were monitored by polysomnography (PSG) by polysomnography. According to the diagnostic criteria of OSAHS and T2DM, the subjects were divided into two groups: OSAHS group (n = 28), OSAHS with T2DM group (n = 28) and T2DM group (n = 28). The serum levels of IGF-1 Amylin were measured by enzyme-linked immunosorbent assay (Elisa) in 28 normal controls (n = 28). 2.Twenty patients with good compliance were selected in OD group. After treatment with nCPAP on January, the levels of IGF-1 and Amylin in serum were determined again. Results 1. Serum IGF-1 levels in DM group and OD group were significantly lower than those in N group. The serum IGF-1 levels in DM group and OD group were significantly lower than those in N group. The serum Amylin levels in DM group and OD group were higher than those in N group. There was also a significant difference in serum Amylin levels between DM group and OD group (P 0.01). 2.The level of serum IGF-1 in OD group after nCPAP treatment was higher than that before treatment. The level of P0.01Amylin in OD group was lower than that before treatment. 3. Serum IGF-1 level was negatively correlated with AHI (P 0.01), positively correlated with LSaO2 and MSaO2 (P 0.01), serum Amylin with AHI (P 0.01), LSaO2 and MSaO2 with negative correlation (P 0.01). Conclusion 1. Intermittent hypoxia is one of the risk factors to decrease the level of serum IGF-1 and increase the level of amylin. 2. IGF-1Amylin can be used as a predictor of hyperglycemia in patients with OSAHS. 3. NCPAP can improve the level of serum IGF-1, amylin and blood glucose in patients with OSAHS and T2DM, and delay the development of type 2 diabetes caused by OSAHS.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R56;R587.1

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