OSAHS合并2型糖尿病行改良悬雍垂腭咽成形术后对血糖影响的临床观察

Clinical observation of the effect of modified uvulopalatopharyngoplasty on blood sugar in OSAHS patients complicated with type 2 diabetes mellitus

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并Ⅱ型糖尿病行改良悬雍垂腭咽成形术(H-UPPP)治疗对血糖的影响。方法经多导睡眠监测(PSG)检查确诊为OSAHS同时合并经内分泌专科确诊为2型糖尿病的患者18例,分别常规采静脉血测手术前空腹血糖12.30±2.50 mmol/L,餐后2 h血糖19.50±3.10 mmol/L、手术后7 d空腹血糖11.20±1.60 mmol/L,餐后2 h血糖15.70±2.40 mmol/L及手术后180 d空腹血糖6.28±0.40 mmol/L,餐后2 h血糖7.65±0.12 mmol/L进行对比分析。结果手术前与手术后7 d空腹和餐后2 h血糖各指标差异无统计学意义(P>0.05),手术前、手术后7 d与手术后180 d空腹和餐后2 h血糖各指标差异有统计学意义(P<0.05)。结论 OSAHS可以成为Ⅱ型糖尿病的病因。OSAHS通过H-UPPP治疗可以改善缺氧,提高机体对胰岛素的敏感性,从而有效控制2型糖尿病的血糖。

Objective To explore the effect of modified uvulopalatopharyngoplasty（H-UPPP） on blood sugar in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） and type 2 diabetes mellitus（T2DM）.Methods Eighteen OSAHS patients complicated with T2DM participated in this study.OSAHS was confirmed by polysomography（PSG） examination.The diagnosis of T2DM was made by endocrinological examinations.Fasting blood sugar and 2 h postprandial blood glucose were detected before and 7 d and 180 d after H-UPPP.The results were analyzed and compared.Results Fasting blood sugar was 12.30±2.50 mmol/L and 2 h postprandial blood glucose was 19.50±3.10 mmol/L before surgery.On postoperative day 7,the fasting blood sugar was 11.20±1.60 mmol/L,2 h postprandial blood glucose was 15.70±2.40 mmol/L.On postoperative day 180,fasting blood sugar was 6.28±0.40 mmol/L,2-h postprandial blood glucose was 7.65±0.12 mmol/L.In comparison with the levels before surgery,the fasting blood sugar and 2-h postprandial glucose level did not exhibit statistical difference（P0.05） on postoperative day 7 day,but showed statistical differences（P 0.05） on postoperative day 180 day.Conclusion OSAHS is a possible cause of type 2 DM.H-UPPP for the treatment of OSAHS can improve hypoxia and the sensitivity of body to insulin,thereby effectively controlling blood sugar levels in diabetes.