持续呼吸道正压通气治疗对2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征患者的疗效及血管内皮细胞功能的影响

Effects of CPAP on OSAHS with T2DM and Influences on Vascular Endothelial Cell Function

目的对2型糖尿病(T2DM)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者进行经鼻持续呼吸道正压通气治疗(CPAP),以评价该疗法的效果及其对血管内皮功能的影响。方法临床确诊T2DM合并OSAHS患者共60例,随机分为治疗组和对照组,其中对照组仅给予常规药物治疗,治疗组给予常规药物的同时进行CPAP治疗。60d后观察两组治疗前后空腹血糖、餐后2h血糖、糖化血红蛋白(Hb A1c)、睡眠呼吸监测参数以及血浆内皮素1(ET-1)和血清一氧化氮(NO)的变化。结果治疗组的空腹血糖、睡眠呼吸暂停低通气指数(AHI)、最长呼吸暂停时间、最低脉搏容积血氧饱和度、血浆ET-1、血清NO与对照组比较差异有统计学意义(P<0.05);而餐后2h血糖、糖化血红蛋白虽有改善,但差异无统计学意义(P>0.05)。结论 CPAP是治疗OSAHS合并T2DM患者的一种安全有效方法,不仅能改善患者睡眠呼吸和血糖,还有利于血管内皮细胞功能的恢复。

Objective To evaluate the efficacy of continuous positive airway pressure（ CPAP） on obstructive sleep apneahyponea syndrome（ OSAHS） combined with Type 2 diabetes mellitus（ T2DM）,and the influences on vascular endothelial cell function. Methods Clinically defined 60 patients of OSAHS combined with T2 DM were divided into two groups randomly. Treatment group was received routine drug treatment and CPAP,while the control group was given routine drug treatment only. After not less than 60 days treatment,the parameters of monitoring sleep respiration,fasting blood glucose,2 hour postprandial blood glucose,glycosylated haemoglobin Alc（ Hb A1c）,plasma endothelin 1（ ET-1） and serum nitric oxide（ NO） were compared between the treatment group and the control group. Results After CPAPtreatment,the data of fasting blood glucose,apnea hypopnea index（ AHI）,maximum apnea duration,minimum pulse oxygen saturation,plasma ET-1,serum NO were significantly difference in treatment group compared to control group（ P 〈0. 05）,but there was no statistically significant difference in glycosylated haemoglobin Alc and 2 hour postprandial blood glucose（ P 〉0. 05）. Conclution CPAP,not only could meliorate the patients＇ sleep breathing and blood sugar,but also improve vascular endothelial function,was a safe and effective treatment for OSAHS with T2 DM.