阻塞性睡眠呼吸暂停低通气综合征患者糖脂代谢与血液流变学相关性分析

发布时间：2018-05-16 20:07

本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 糖脂代谢　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的探讨阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea Hypopnea Syndrome,OSAHS)患者糖脂代谢对血液流变学的影响。方法依据诊断标准,选择OSHAS患者组70例和同期健康对照组20例,OSAHS患者组分为轻度组17例,中度组25例,重度组28例。入选者均测量身高、体重,计算体重指数(BMI)。所有受试人员均进行多导睡眠监测,记录呼吸暂停低通气指数(AHI)、最低血氧饱和度(Minimum oxygen saturation,Min SPO2),测定空腹血糖、血脂、脂联素、血液流变学指标。比较OSAHS患者组中各组与对照组空腹血糖、血脂、脂联素、血液流变学等各项指标间的差异,并进行OSAHS患者组血液流变学各指标与糖脂代谢各指标、呼吸暂停低通气指数、最低血氧饱和度、体重指数的相关性分析。结果1.OSHAS患者组与对照组比较:血糖、胆固醇、甘油三脂、全血粘度、血浆粘度、全血粘度高切、全血粘度低切、红细胞聚集指数较对照组均升高(P0.05),高密度脂蛋白、脂联素、红细胞变形指数较对照组均降低(P0.05)。2.OSHAS患者组中各组与对照组比较:脂联素在各组中随病情加重逐渐降低(P0.05),两两比较差异显著(P0.05);血糖、胆固醇、甘油三脂、全血粘度、血浆粘度、全血还原高切、全血还原低切在OSHAS患者组中随病情加重逐渐升高(P0.05),轻度组与对照组无差异(P0.05);红细胞变形指数在OSHAS患者组中随病情加重逐渐降低(P0.05),轻度组与对照组无差异(P0.05);重度组及中度组的高密度脂蛋白较对照组降低(P0.05),重度组降低程度与轻度组相比(P0.05),其余各组比较无差异(P0.05);重度组红细胞压积较中度组、轻度组、对照组升高(P0.05);重度组及中度组的红细胞聚集指数较轻度组、对照组升高(P0.05),重度组与中度组无差异(P0.05)。3.经直线相关分析血液流变学各指标与糖脂代谢各指标、AHI、最低血氧饱和度、体重指数等有不同程度相关(P0.05)。进一步多元线性逐步回归中,以血液流变学各指标为应变量,以糖脂代谢各指标、AHI、最低血氧饱和度、体重指数为自变量,建立回归方程,从自变量变化中可以推测血液流变学的特征。结论OSHAS患者中存在糖脂代谢紊乱和血液流变学异常:血糖、甘油三脂、胆固醇、全血粘度、血浆粘度、全血粘度高切、全血粘度低切、红细胞聚集指数均升高,与病情严重程度呈正相关,脂联素、高密度脂蛋白、红细胞变形指数均降低,与病情严重程度呈负相关。经相关分析,糖脂代谢各指标与血液流变学各指标显著相关,糖脂代谢紊乱是血液流变学发生改变的原因之一。
[Abstract]:Objective to investigate the effect of glucose and lipid metabolism on hemorheology in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods according to the diagnostic criteria, 70 patients with OSHAS and 20 healthy controls were divided into mild group (n = 17), moderate group (n = 25) and severe group (n = 28). Height and weight were measured and body mass index (BMI) was calculated. All subjects were monitored with polysomnography, apnea hypopnea index (AHIH) and minimum oxygen saturation (MOS) were recorded. Fasting blood glucose, blood lipid, adiponectin and hemorheology were measured. The differences of fasting blood glucose, blood lipid, adiponectin and hemorheology were compared between the OSAHS group and the control group. The indexes of hemorheology, glucose and lipid metabolism, apnea hypopnea index and so on in the OSAHS group were compared. Correlation analysis of minimum oxygen saturation and body mass index. Results the levels of blood glucose, cholesterol, triglyceride, whole blood viscosity, plasma viscosity, whole blood viscosity were high, whole blood viscosity was low, erythrocyte aggregation index (RBC) was higher than control group (P 0.05), high density lipoprotein (HDL), adiponectin (adiponectin). The erythrocyte deformability index was lower than that of the control group (P 0.05) .2.Compared with the control group, adiponectin decreased gradually with the severity of the disease in each group, the difference was significant (P 0.05), the blood glucose, cholesterol, triglyceride, whole blood viscosity, plasma viscosity, blood glucose, cholesterol, triglyceride, whole blood viscosity, plasma viscosity, Whole blood reduced to high shear, In the OSHAS group, the whole blood reduction decreased gradually with the severity of the disease (P0.05), but there was no difference between the mild group and the control group (P0.05). The erythrocyte deformability index decreased gradually with the exacerbation of the disease in the OSHAS group, and there was no difference between the mild group and the control group (P0.05), while in the severe group, the erythrocyte deformability index decreased gradually (P0.05). The high density lipoprotein in the moderate group was lower than that in the control group (P 0.05), the degree of decrease in the severe group was higher than that in the mild group, and the other groups had no difference (P 0.05), and the hematocrit in the severe group was higher than that in the moderate group. The erythrocyte aggregation index of the severe and moderate groups was higher than that of the mild group, while that of the control group was higher than that of the mild group. There was no difference between the severe group and the moderate group. By linear correlation analysis, the hemorheology indexes were correlated with AHI, the lowest oxygen saturation, body mass index and so on. There was a different correlation between the indexes of hemorheology and glycolipid metabolism (P 0.05). In the further multivariate linear stepwise regression, the regression equation was established with the indexes of hemorheology as dependent variables, AHI, minimum oxygen saturation and body mass index as independent variables. The characteristics of hemorheology can be inferred from the variation of independent variables. Conclusion there are hyperglycemia, triglyceride, cholesterol, whole blood viscosity, plasma viscosity, whole blood viscosity high shear, whole blood viscosity low shear and erythrocyte aggregation index increased in patients with OSHAS. Adiponectin, high density lipoprotein and erythrocyte deformability index were positively correlated with the severity of the disease, but negatively correlated with the severity of the disease. By correlation analysis, the indexes of glucose and lipid metabolism were significantly correlated with the indexes of hemorheology, and the disorder of glucose and lipid metabolism was one of the reasons for the change of hemorheology.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766

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