探讨阻塞性睡眠呼吸暂停综合征对2型糖尿病患者血糖控制及相关慢性并发症的影响

Effects of obstructive sleep apnea syndrome on blood glucose control and related chronic compli- cations in patients with type 2 diabetes

目的探讨2型糖尿病合并阻塞性睡眠呼吸暂停综合征（OSAS）患者的血糖控制及相关慢性并发症的发生情况。方法随机选取2014年6月至2015年9月收治的2型糖尿病患者140例，根据便携式睡眠呼吸监测仪监测结果将其分为观察组（合并OSAS）和对照组（未合并OSAS）。对两组患者的空腹血糖、餐后2h血糖、胰岛素抵抗指数、糖化血红蛋白水平进行检测记录，并对两组患者糖尿病肾病、糖尿病视网膜病变、糖尿病周围神经病变、高血脂及高血压等并发症的发生情况进行观察记录。结果观察组空腹血糖、餐后2h血糖、糖化血红蛋白、胰岛素抵抗指数均明显高于对照组，差异有统计学意义（P〈0．05）；合并OSAS与糖尿病视网膜病变、糖尿病周围神经病变呈正相关（P〈0．05），而是否合并OSAS与糖尿病肾病并无明显相关性（P〉0．05）。结论OSAS易对2型糖尿病患者的血糖控制水平造成不利影响，且会造成患者糖尿病慢性并发症的发生风险上升，建议在日常治疗中对其加以合理控制。

Objective To investigate the chronic glycemic control and related complications of type 2 diabetes patients with obstructive sleep apnea syndrome （OSAS）. Methods From June 2014 to September 2015, 140 cases of type 2 diabetic patients were randomly selected, and they were divided in- to observation group （patients with OSAS） and the control group （unconsolidated OSAS） according to the portable sleep apnea monitor monitoring results. The fasting blood glucose, postprandial 2 h blood glucose, insulin resistance index, glycated hemoglobin levels of the two groups were detected, and the occurence of diabetic nephropathy, diabetic retinopathy, diabetic peripheral neuropathy, high cholesterol and high blood pressure were observed and recorded. Results FBG, 2 h BG, HbAlc, mean HOMA-IR in observation group were significantly higher than those in control group, and the differences were signif- icant （ P 〈 0.05 ）. OSAS was positively correlatied with DR and DPN （ P 〈 0.05 ）, but was not correla-ted with DN （P 〉 0.05）. Conclusions OSAS is easy to cause adverse effects on blood glucose control in type 2 diabetes, and will result in the increase of chronic complications of diabetes patients , so it is recommended to be in reasonable control of daily therapy.