持续气道正压通气治疗老年阻塞性睡眠呼吸暂停低通气综合征合并糖尿病的临床分析

Clinical Analysis of Continuous Airway Positive Pressure Ventilation in Patients with Obstructive Sleep Apnea Syndrome Combined with Diabetes Mellitus

目的研究持续气道正压通气(CPAP)对老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并糖尿病患者的疗效。方法选取OSAHS合并糖尿病患者80例,随机分为对照组和治疗组,各40例。对照组给予糖尿病饮食、降血糖药物等常规治疗;治疗组在常规治疗基础上,同时使用福通ST-25持续气道正压通气呼吸机治疗;监测治疗前后空腹血糖(FPG)、餐后2 h血糖(2 hPG)及胰岛素、睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSpO2)、最长呼吸暂停时间。结果经治疗4周后,治疗组的FPG、2 hPG、AHI和最长呼吸暂停时间均低于对照组;空腹胰岛素、餐后2 h胰岛素、LSpO2均高于对照组(均P<0.01)。结论 CPAP治疗老年OSAHS合并2型糖尿病患者可有效降低血糖水平,改善AHI、LSpO2和最长呼吸暂停时间。

Objective To study the curative effect of continuous positive airway pressure （CPAP） on elderly patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） complicated with diabetes mellitus. Methods Eighty patients with OSAHS and diabetes mellitus were included and randomly divided into treatment group （n=40） and control group （n=40）. The control group was given conventional treatment including diabetes diet and hypoglycemic drugs. The treatment group was given Futong ST-25 continuous positive airway pressure （CPAP） ventilation besides the conventional treatment. The serum levels of fasting blood glucose （FBG）, two-hour postprandial blood glucose （2 hPG）, insulin, sleep apnea hypop-nea index （AHI）, low oxygen saturation （LSpO2） and the longest apnea time were monitored before and after treatment in two groups. Results After four-week treatment, values of FPG, 2 hPG, AHI and the longest apnea time were significantly lower in treatment group than those in control group （P ＆lt; 0.01）, but values of insulin, two-hour postprandial insulin and LSpO2 were significantly higher in treatment group than those in control group （P＆lt;0.01）. Conclusion CPAP therapy can effec-tively decrease blood sugar level and improve AHI, LSpO2 and the longest apnea time in elderly patients with OSAHS compli-cated with type 2 diabetes.