阻塞性睡眠呼吸暂停低通气综合征合并2型糖尿病患者血清单核细胞趋化蛋白-1、胱抑素C水平的变化

发布时间：2018-08-02 20:18

【摘要】：目的：观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及OSAHS合并2型糖尿病(T2DM)患者血清单核细胞趋化蛋白-1(MCP-1)、胱抑素C（Cys C）的变化，探讨它们在OSAHS及其合并T2DM发病过程中可能的作用机制。分析经鼻持续气道内正压通气（nCPAP）治疗对OSAHS合并T2DM患者血清MCP-1、Cys C及血糖水平的影响。方法：选取2010年10月至2011年7月在我院就诊，并行不少于7小时多导睡眠图监测（PSG）及快速空腹血糖（FPG）检测。诊断标准参照《阻塞性睡眠呼吸暂停低通气综合征诊治指南（草案）》、《中国2型糖尿病防治指南》。所有研究对象的性别、年龄、体重指数（BMI）间有均衡性，均排除心、脑、肾、肺、肝脏等重要脏器的器质性改变，均签署知情同意书。分为OSAHS合并T2DM组(OD组)、单纯OSAHS组（O组）、单纯T2DM组（DM组）、正常对照组（N组）4组，每组各28例，采用酶联免疫法（ELISA）检测各组研究对象血清MCP-1、Cys C的水平。另选取20例中重度OSAHS合并T2DM患者接受1月经鼻持续气道正压通气（nCPAP）治疗后，再次检测血清MCP-1、Cys C的水平。最后进行相关统计分析。结果：1.与N组研究对象比较，O组、DM组、OD组患者血清MCP-1、Cys C水平升高（均P0.05），OD组水平最高。O组与DM组患者血清MCP-1、Cys C比较差异无显著性（均P0.05）。 2.OD组患者血清MCP-1、Cys C水平较治疗前下降（均P0.05）。 3.血清MCP-1水平与呼吸暂停指数（AHI）呈正相关，与最低血氧饱和度（LSO2）、平均血氧饱和度（MSO2）呈负相关；血清Cys C水平与AHI呈正相关，与LSO2、MSO2呈负相关(均P0.05)。 4.血清MCP-1、Cys C与FPG呈正相关(均P0.05)。结论：1.血清MCP-1、Cys C可能参与OSAHS合并T2DM的发生发展。 2.血清MCP-1、Cys C水平的变化可反映OSAHS患者病情严重程度及低氧血症严重程度。 3.nCPAP治疗可改善OSAHS合并T2DM患者的病情，使MCP-1、Cys C水平下降，从而起到一定的治疗作用。
[Abstract]:Objective: to observe the changes of monocyte chemoattractant protein 1 (MCP-1) and cystatin C (Cys C) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and OSAHS with type 2 diabetes mellitus (T2DM), and to explore their possible mechanism in the pathogenesis of OSAHS and T2DM. To analyze the effect of nasal continuous positive airway pressure ventilation (nCPAP) on serum MCP-1C and blood glucose levels in patients with OSAHS complicated with T2DM. Methods: (PSG) and fast fasting blood glucose (FPG) were detected by polysomnography and fast fasting blood glucose in our hospital from October 2010 to July 2011. Diagnostic criteria refer to the guidelines for the diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (draft) and Chinese guidelines for the prevention and treatment of type 2 diabetes. Gender, age and body mass index (BMI) of all subjects were balanced, and the organic changes of heart, brain, kidney, lung, liver and other important organs were excluded, and informed consent was signed. OSAHS combined with T2DM (OD group), simple OSAHS group (O group), simple T2DM group (DM group) and normal control group (N group) were divided into 4 groups (28 cases in each group). The serum MCP-1Cys C levels were detected by enzyme-linked immunosorbent assay (ELISA). In addition, 20 patients with moderate and severe OSAHS combined with T2DM were treated with nasal continuous positive airway pressure (nCPAP) in January, and the serum MCP-1Cys C levels were determined again. Finally, the related statistical analysis is carried out. The result is 1: 1. Compared with group N, the serum MCP-1Cys C level in DM group (P 0.05) was higher than that in group N (P 0.05). There was no significant difference between group O and DM group (P 0.05). There was no significant difference between group O and group DM (P0.05). The level of serum MCP-1cys C in patients with 2.OD was higher than that in patients with diabetes mellitus (P 0.05). Before the decrease (P0.05). 3. Serum MCP-1 level was positively correlated with apnea index (AHI), negatively correlated with minimum oxygen saturation (LSO2) and mean oxygen saturation (MSO2), and serum Cys C level was positively correlated with AHI and negatively correlated with LSO _ 2M _ 2 _ 2 (P0.05). There was a positive correlation between serum MCP-1 and FPG (P 0.05). Conclusion 1. Serum MCP-1 Cys C may be involved in the occurrence and development of OSAHS combined with T2DM. 2. The change of serum MCP-1Cys C level can reflect the severity of OSAHS and hypoxemia. 3.nCPAP treatment can improve the condition of OSAHS patients with T2DM and decrease the level of MCP-1Cys C, and thus play a therapeutic role.
【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】：R766;R587.1

【相似文献】