阻塞性睡眠呼吸暂停低通气综合（OSAHS）患者手术治疗前后瘦素、血脂水平的变化

发布时间：2018-03-30 01:26

  本文选题：阻塞性睡眠呼吸暂停低通气综合征(OSAHS)　切入点：瘦素　出处：《延边大学》2011年硕士论文

【摘要】：目的：观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者采用改良式UPPP和(或)鼻内镜下鼻中隔成形手术治疗前后瘦素、血脂的变化。用于对OSAHS的早期筛查和诊断,评价手术远期治疗效果。 方法： 1、选择OSAHS患者24例,患者年龄25-61(43.37±9.32)岁。体重指数25.91±2.73kg/M2,所有患者均有夜间睡眠中打鼾、呼吸暂停及白天嗜睡等病史,经纤维鼻咽喉镜检和多导睡眠仪(polysomnography,PSG)监测确诊。 2、选择OSAHS手术后(术后半年至一年)患者22例,患者年龄23--62(42.67±10.25)岁,体重指数24.68±2.52kg/M2,所有患者均经多导睡眠仪(polysomnography, PSG)监测。 3、选择健康对照组20例,年龄21-60(42.69±9.64)岁,体重指23.78±2.66 kg/m2。所有研究对象均除外高血压、慢性肺部病变、神经肌肉疾病、甲状腺疾病及其他内分泌疾病、营养代谢疾病、冠心病、脑血管意外等其他全身疾病。 所有入选者在睡眠监测结束,晨醒10分钟内抽取肘腹静脉血6ml,分别应用酶联免疫法检测血清瘦素(Leptin)水平及用全自动生化分析仪检测血脂水平,包括总胆固醇(total cholestein,TC)、甘油三酯(triglyceride, TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholestein, LDL-C)、高密度之蛋白胆固醇(high-density lipoprotein cholestein, HDL-C)。 所有资料均应用SPSS17.0统计软件进行统计学处理,记量资料以x±S表示,多组间均数比较采用单因素方差分析,两变量间的相关性采用直线相关分析,P0.05表示有统计学意义。 结果： 1、OSAHS术后组与OSAHS组患者比较Leptin降低、TC降低、TG降低、LDL-C降低、HDL-C升高。P0.01,具有统计学意义。 2. OSAHS术后组患者与健康对照组比较Leptin、TC、TG、LDL-C、HDL-C, p0.05,无统计学意义。 3、直线相关分析显示： OSAHS组患者Leptin与AHI呈正相关(r=0.547)；与最低SaO2呈负相关(r=-0.334)；与BMI呈正相关(r=0.384)；与TC呈正相关(r=0.636),与TG呈正相关(r=0.524),与LDL-C呈正相关(r=0.671);HDL-C呈负相关(r=-0.723)；TC与AHI正相关(r=0.692),与最低SaO2呈负相关(r=-0.254)；TG与AHI呈正相关(r=0.734),与最低SaO2呈负相关(r=-0.482);LDL-C与AHI呈正相关(r=0.587),与最低SaO2负相关(r=-0.143);HDL-C与AHI呈负相关性(r=-0.625),与最低SaO2呈正相关(r=0.175)。 结论 OSAHS患者存在瘦素水平、血脂的紊乱,经改良式UPPP和(或)鼻内镜下鼻中隔成形手术治疗Ⅰ型和Ⅱ型OSAHS患者后可以证实,缺氧得到改善,瘦素、血脂水平得到逆转。检测瘦素和血脂有助于OSAHS早期筛查,预防并发症,用于OSAHS病人的流行病学调查指标；并可用于观察手术远期疗效的测定指标。
[Abstract]:Objective: to observe the changes of leptin and serum lipids in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after nasal septoplasty with modified UPPP and / or nasal endoscope. To evaluate the effect of long-term surgical treatment. Methods:. 1. Twenty-four patients with OSAHS were selected. The age of the patients was 25-61kg, 43.37 卤9.32 years old. The BMI was 25.91 卤2.73kg / m2. All the patients had a history of snoring, apnea and daytime sleepiness during night sleep, which were confirmed by fiberoptic nasolaryngoscopy and polysomnography PSG. 2Twenty two patients (half a year to one year after OSAHS) were selected. The patients were aged from 23 to 62.67 卤10.25 years old and had a body mass index of 24.68 卤2.52 kg / m2. All the patients were monitored by polysomnography (PSG). 3Twenty healthy control subjects, aged 21-60 years, 42.69 卤9.64 years old, weight index 23.78 卤2.66 kg / m2. All subjects were excluded hypertension, chronic pulmonary disease, neuromuscular disease, thyroid disease and other endocrine diseases, nutritional metabolic disease, coronary heart disease. Cerebrovascular accident and other systemic diseases. At the end of sleep monitoring, 6 ml of venous blood was drawn from the elbow ventral vein within 10 minutes of waking in the morning. The serum leptin Leptin level was detected by enzyme-linked immunosorbent assay (Elisa) and the blood lipid level was measured by automatic biochemical analyzer. These include total total cholesterol, triglyceride, triglyceride, low density lipoprotein cholesterol, low density lipoprotein cholesteatrin, high density protein cholesterol, high density lipoprotein cholesteate, and high density protein cholesterol. All the data were processed by SPSS17.0 statistical software, the recording data were expressed as x 卤S, the mean of multiple groups was analyzed by single factor ANOVA, and the correlation between the two variables was expressed by linear correlation analysis (P0.05). Results:. 1 compared with OSAHS group, Leptin decreased TC, TG decreased, LDL-C decreased and HDL-C increased in OSAHS group compared with OSAHS group, which had statistical significance. 2. There was no significant difference in HDL-C (p0.05) between OSAHS group and healthy control group. 3. Linear correlation analysis shows that:. In OSAHS group, there was a positive correlation between Leptin and AHI, a negative correlation with minimum SaO2, a negative correlation with SaO2, a positive correlation with BMI, a positive correlation with TC, a positive correlation with TC, a positive correlation with TG, a positive correlation with TG, a negative correlation with LDL-C, a positive correlation between TC and AHI, and a negative correlation between TC and AHI. There was a positive correlation between AHI and minimum SaO2, a positive correlation between LDL-C and AHI, a negative correlation between LDL-C and AHI, a negative correlation between HDL-C and AHI, and a positive correlation between LDL-C and minimum SaO2. Conclusion. Leptin levels and dyslipidemia were found in patients with OSAHS. After modified UPPP and / or nasal endoscopic septoplasty for patients with type I and type 鈪，

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