UPPP手术对阻塞性睡眠呼吸暂停低通气综合征患者胰岛素敏感性的影响

Change of Insulin Sensitivity in Patients with Obstructive Sleep Apnea Hypopnea Syndrome After the Operation of Uvulopalatopharyngoplasty

【目的】探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者悬雍垂腭咽成形术（UPPP）手术前后胰岛素敏感性的变化。【方法】选择伴血糖紊乱的OSAHS患者20例行多导睡眠监测（PSG）检查及UPPP手术，并于术前及术后6个月进行PSG检查及空腹血糖、糖化血红蛋白、空腹胰岛素水平检测，计算胰岛素敏感指数（ISI）分析其变化关系。【结果】经过UPPP手术治疗后，患者的呼吸暂停低通气指数（AHI）及最低血氧饱和度（LSaO2）明显改善（P〈0．05），空腹血糖、糖化血红蛋白水平较术前降低，胰岛素敏感性较术前升高（P〈0．05）。【结论】UPPP手术治疗能改善伴糖代谢紊乱的OSAHS患者低血氧的情况，增加其胰岛素的敏感性。

[Objective]To explore the change of insulin sensitivity in patients with obstructive sleep apnea hypopnea syndrome （OSAHS） after uvulopalatopharyngoplasty （UPPP） . [Methods]Twenty OSAHS patients were monitored by polysomnography （PSG） . The apnea hypopnea index （AHI） and LSaO2 were evaluated. The levels of fasting plasma glucose, HbAlc, insulin and insulin sensitivity index （ISI） were measured before and after operation. [ResultS] The levels of AHI and LSaO2 in the OSAHS patients before UPPP were significantly higher than those after UPPP therapy （ P 〈0.05）. The fasting plasma glucose and HbAlc obviously descended and the level of ISI improved compared with that before UPPP therapy （ P 〈0.05）. [Conclusion] The UPPP surgical procedures can improve the hypoxia of patients and enhance the ISI.