OSAS对冠心病患者的血糖和血脂水平的影响

Influence of OSAS on Glucose and Serum Lipid Levels in Patients with Coronary Heart Disease

目的:探讨阻塞性睡眠呼吸暂停综合征(Obstructive sleep apnea syndrome,OSAS)对冠心病患者血糖和血脂的影响。方法:纳入我科住院的明确诊断冠心病患者共168人,根据呼吸暂停低通气指数(Apnea-hypopnea index,AHI)共分2组:冠心病组133例,冠心病合并OSAS组45例(轻度OSAS组16例;中度OSAS组18例,重度OSAS组12例)。对比分析冠心病组和冠心病合并OSAS组患者血脂及血糖水平及其相关性。结果:BMI、LDL、HDL在四组间差异有统计学意义(P<0.05)。冠心病合并OSAS的BMI、LDL、HDL明显高于冠心病组,各组间BMI差异有统计学意义(P<0.05)。FPG、HOMA-I、RHb A1、OX-LDL、AHI在冠心病组和冠心病合并轻度OSAS组之间差异无统计学意义(P>0.05)。FPG、HOMA-I、RHb A1、OX-LDL、AHI在OSAS轻、中、重各组间差异有统计学意义(P<0.05)。冠心病合并OSAS患者AHI和BMI、LDL、FPG、HOMA-I、OX-LDL呈正相关关系(P<0.05)。结论:OSAS增加了冠心病患者血脂水平和糖尿病的风险,及机制可能与胰岛素抵抗和OX-LDL水平增高有关。

Objective： To investigate the influence of obstructive sleep apnea syndrome（OSAS） on glucose and serum lipid in patients with coronary heart disease. Methods： A total of 168 people diagnosed with coronary heart disease were included in this research.They were divided into two groups： the first group of 133 cases with coronary heart disease（CHD） and the second group of coronary heart disease combined with OSAS group of 45 cases（16 cases in mild OSAS group, 18 cases in moderate OSAS group, 12 cases in severe OSAS group） according to the Apnea hypoventilation index（AHI）. The levels of serum lipid and glucose and their relevance were analyzed and compared between groups. Results： The levels of BMI, LDL and HDL had statistical difference between the four groups.The levels of BMI, LDL and HDL in CHD with OSAS group were significantly higher than in CHD group（P〈0.05）. There was no difference in FPG, HOMA-I, RHb A1, OX-LDL, AHI between CHD with mild OSAS group and CHD group（P〉0.05）. There was statistically significant difference in FPG, HOMA-I, RHb A1, OX-LDL, AHI between light, medium and heavy groups（P〈0.05）. AHI in patients of CHD combined with OSAS group had positive relationship with BMI, LDL, FPG, HOMA-I and OX-LDL（P〈0.05）. Conclusion： OSAS increases the risk of coronary heart disease patients with high serum lipid levels and diabetes, and the mechanism may be related to insulin resistance and OX-LDL increase.