代谢综合征并发睡眠呼吸暂停发病机制

Pathogenesis of metabolic syndrome combined with obstructive sleep apnea hypopnea syndrome

目的探讨中年人代谢综合征并发睡眠呼吸暂停患者临床并存率较高的发病机制与治疗方法。方法回顾分析患者呼吸机治疗6个月前后多导睡眠监测结果、外周循环血代谢参数及腰围值等数据,并行对比分析。结果所有重度睡眠呼吸暂停综合征得到了改善,患者中代谢综合征并存率由治疗前100%降到治疗后的20%,有显著临床意义,但代谢参数值变化比较差异无统计学意义。结论呼吸机治疗对重度睡眠呼吸暂停综合征及代谢综合征均有效,提示积极干预治疗睡眠呼吸暂停综合征,同时也可治疗代谢综合征。睡眠呼吸暂停综合征可能是代谢综合征病情发展的一个重要因素。

Objective To investigate the associated pathogenesis and therapeutic methods of higher clinical coexistence of metabolic syndrome （MS） and obstructive sleep apnea hypopnea syndrome （OSAHS） in middle - aged patients. Methods Retrospective and contrast analysis of 30 patients＇ PSG results before and after 6 months with therapy by NPPV were carried out. Apnea hypopnea index （ AHI）, the lowest pulse oxygen saturation （LSpO2 during sleep respectively）, mean pulse oxygen saturation （meanSpO2 ）, MS -associated parameters - fasting blood glucose （FBG） total cholesterol （ TCH ）, triglyceride （ TG）, high - density lipoprotein cholesterol （ HDL）, low - density lipoprotein cholesterol （LDL） , blood pressure （ BP）, BMI, waist circumference （WC） were measured. Results Severe OSAHS were found in all patients with MS. The incidences of MS in severe OSAHS were significantly higher than before therapy by NPPV. There was a significant improvement in AHI, nocturnal LSpO2, and mean SpO2. There was no statistically significant depress in TCH, LDL, TG, HDL and WC. Conclusion The association between OSAHS and MS is confirmed. Sleep apnea is a manifestation of the metabolic syndrome. CPAP treatment to changes in MS are related to changes in obstructive sleep apnoea syndrome patients.