持续气道正压通气治疗对2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征患者血清视黄醇结合蛋白4和脂联素的影响

发布时间：2019-04-04 16:22

【摘要】：目的探讨T2DM合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者在持续正压通气治疗(CPAP)前后血清视黄醇结合蛋白4(RBP4)及APN的变化规律。方法选取2014年6月至2016年10月于上海交通大学医学院附属同仁医院内分泌科、呼吸内科住院的T2DM合并OSAHS患者155例,随机分为CPAP治疗组(CPAP)73例和常规治疗对照组(Con)77例,测定治疗前、后12周呼吸参数变化,以及治疗前、治疗后4周、8周、12周的血清RBP4、APN、FPG、FIns,计算胰岛素抵抗指数(HOMAIR)。结果 CPAP组各项呼吸参数改善,血清APN升高程度高于Con组,4周、8周及12周分别为(7.92±3.15)vs(6.87±3.06)mg/L,(8.99±5.46)vs(7.15±3.20)mg/L,(11.68±4.65)vs(8.34±3.25)mg/L(F_(交互)=13.980,P=0.000),其升高程度随着治疗时间增加而增加(F_(时间)=26.574,P=0.000);血清RBP4降低程度低于Con组,4周、8周、12周分别为(22.10±2.82)vs(23.84±3.51)μg/L,(19.52±3.02)vs(22.98±4.07)μg/L,(16.43±2.56)vs(20.15±3.24)μg/L(F_(交互)=11.057,P=0.000),其降低幅度随着治疗时间增加而减少(F_(时间)=23.056,P=0.000)。结论 CPAP治疗能有效纠正T2DM合并OSAHS患者的低氧血症,改善IR,而RBP4和APN可作为监测病情转归、判断预后的有效指标。
[Abstract]:Objective to investigate the changes of serum retinol binding protein 4 (RBP4) and APN in patients with T2DM combined with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after continuous positive pressure ventilation (CPPV). Methods from June 2014 to October 2016, in the Department of Endocrinology, affiliated Hospital of Medical College of Shanghai Jiaotong University, 155 patients with T2DM complicated with OSAHS were randomly divided into two groups: CPAP group (73 cases) and routine treatment group (77 cases). The changes of respiratory parameters were measured before and 12 weeks after treatment, and the insulin resistance index (HOMAIR).) was calculated by serum RBP4,APN,FPG,FIns, at 4, 8, and 12 weeks before treatment, and at 4, 8 and 12 weeks after treatment. Results the respiratory parameters were improved in CPAP group. The level of serum APN in Con group was higher than that in Con group. The levels of serum APN were (7.92 卤3.15) vs (6.87 卤3.06) mg/L, (8.99 卤5.46) vs (7.15 卤3.20) mg/L, at 4, 8 and 12 weeks, respectively. (11.68 卤4.65) vs (8.34 卤3.25) mg/L (F _ (interaction) = 13.980, P < 0.000), and the degree of increase increased with the increase of treatment time (F _ (time) = 26.574, P < 0.000). The level of serum RBP4 was lower in Con group than that in Con group (22.10 卤2.82) vs (23.84 卤3.51 渭 g / L vs (19.52 卤3.02) vs (22.98 卤4.07) 渭 g / L at 4 weeks, 8 weeks and 12 weeks, respectively). (16.43 卤2.56) vs (20.15 卤3.24) 渭 g / L (F _ (interaction) = 11.07, P < 0.000), and the decreasing range decreased with the increase of treatment time (F _ (time) = 23.056, P = 0.000). Conclusion CPAP therapy can effectively correct hypoxemia in T2DM patients with OSAHS and improve IR,. RBP4 and APN can be used as effective indicators to monitor the prognosis of the patients and to judge the prognosis.
【作者单位】：上海交通大学医学院附属同仁医院内分泌科;上海交通大学医学院附属同仁医院急诊科;上海交通大学医学院附属同仁医院呼吸内科;上海交通大学附属第一人民医院内分泌科;
【基金】：上海市长宁区科学技术委员会科研基金(CNKW2014Z02)
【分类号】：R587.1;R766

【相似文献】