阻塞性睡眠呼吸暂停低通气综合征患者血清代谢指标分析及其临床意义

发布时间：2018-11-08 19:54

【摘要】：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清代谢指标的改变及其临床意义。方法:对95例疑似OSAHS患者进行PSG检查,根据PSG结果将患者分为OSAHS组65例和非OSAHS组(对照组)30例。对所有患者抽取静脉血进行生化指标检测,记录尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、空腹血糖(FG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等代谢指标。根据AHI、LSaO2将患者进一步分为轻中度OSAHS组和重度OSAHS组、轻中度低氧组和重度低氧组,比较分析OSAHS组和对照组之间以及不同程度OSAHS组间上述代谢指标的差异。结果:OSAHS组血清Cr、UA、TG的含量明显高于对照组,HDL-C的含量明显低于对照组(P0.01或P0.05),而BUN、FG、TC、LDL-C的血清含量在两组间的差异无统计学意义(P0.05)。轻中度OSAHS组患者血清TG含量明显低于重度OSAHS组(P0.01),其他各项指标的差异均无统计学意义(P0.05);轻中度低氧组血清BUN、UA和TG含量明显低于重度低氧组,HDL-C含量明显高于重度低氧组(P0.01或P0.05);两组患者血清Cr、FG、TC和LDL-C含量则无显著性差异(P0.05)。结论:OSAHS对患者的代谢指标能够产生较大影响,引起代谢指标改变的主要因素是OSAHS所致的低氧血症和高碳酸血症。AHI值的高低不能很好地反映OSAHS患者的低氧程度,对代谢指标的影响较小,临床上应结合LSaO2对OSAHS患者的严重程度进行综合评判。
[Abstract]:Objective: to investigate the changes and clinical significance of serum metabolic indexes in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: 95 patients with suspected OSAHS were examined by PSG. According to the results of PSG, the patients were divided into OSAHS group (n = 65) and non-OSAHS group (n = 30). Blood samples were taken from all patients to detect the biochemical indexes. (BUN), creatinine, urea nitrogen, creatinine, (Cr), uric acid, (UA), fasting blood glucose, (FG), total cholesterol, (TC), triglyceride, (TG), were recorded. High density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and other metabolic indicators. According to AHI,LSaO2, the patients were further divided into mild and moderate OSAHS group and severe OSAHS group, mild to moderate hypoxia group and severe hypoxia group. The difference of the above metabolic indexes between OSAHS group and control group and between different degree OSAHS group was compared and analyzed. Results: the content of serum Cr,UA,TG and HDL-C in OSAHS group were significantly higher than those in control group (P0.01 or P0.05), while BUN,FG,TC, content was significantly lower than that in control group (P0.01 or P0.05). There was no significant difference in serum content of LDL-C between the two groups (P0.05). The level of serum TG in mild to moderate OSAHS group was significantly lower than that in severe OSAHS group (P0.01), and there was no significant difference in other indexes (P0.05). The content of serum BUN,UA and TG in mild to moderate hypoxia group was significantly lower than that in severe hypoxia group, and the content of HDL-C was significantly higher than that in severe hypoxia group (P0.01 or P0.05). There was no significant difference in serum Cr,FG,TC and LDL-C levels between the two groups (P0.05). Conclusion: OSAHS has a great influence on the metabolic indexes of the patients. The main factors causing the changes of the metabolic indexes are hypoxemia and hypercapnia induced by OSAHS. The AHI value can not reflect the degree of hypoxia in OSAHS patients. The effect of LSaO2 on the metabolic indexes was small, so the severity of OSAHS should be evaluated with LSaO2.
【作者单位】：齐齐哈尔市第一医院耳鼻咽喉-头颈外科;哈尔滨医科大学附属第二医院耳鼻咽喉-头颈外科;
【分类号】：R766

【参考文献】