阻塞性睡眠呼吸暂停综合征对冠心病患者糖脂代谢的影响性研究

Research on the impact of obstructive sleep apnea syndrome on blood glucose and lipid metabolism in patients with coronary artery diseases

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)对冠心病患者血糖和血脂代谢的影响。方法在我院心内科和呼吸科住院确诊为冠心病的患者200例,根据呼吸暂停低通气指数(AHI)分为两组:冠心病组155例,冠心病合并OSAS组45例(轻度OSAS组15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与AHI的相关性。结果冠心病合并OSAS组患者的BMI、LDL明显高于冠心病组,而HDL显著低于冠心病组,差异均具有统计学意义(P<0.05)。FPG、HOMA-IR、Hb A1C、OX-LDL、AHI在OSAS轻、中、重各组间差异有统计学意义(P<0.05)。另外,冠心病合并OSAS患者的AHI和BMI、LDL、FPG、HOMA-IR、OX-LDL呈显著性正相关(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,可能与增加胰岛素抵抗和OX-LDL水平有关。

Objective To study the influence of obstructive sleep apnea syndrome（OSAS） on blood glucose and lipid metabolism in patients with coronary artery diseases. Methods A total of 200 patients who were diagnosed with coronary heart disease（CAD） in the cardiology and respiratory medicine departments of our hospital were recruited. According to the apnea hypopnea index（AHI） , 200 patients were divided into 2 groups including the CAD group of 155 cases and the CAD combined with OSAS group of 45 cases（15 cases of mild OSAS. 18 cases of moderate OSAS, and 12 cases of severe OSAS）. The comparative analysis was performed to compare and analyze the blood glucose and lipid levels between the two groups and their correlations with AHI. Results The BMI, LDL, and HDL in the CAD combined with OSAS group were significantly higher than those in the CAD group. The differences were statistically significant（P 〈 0.05）. The FPG, HOMA-I, RHbA1, OX-LDL, and AHI among the mild, moderate and severe OSAS subgroups were statistically significant （P 〈 0.05）. In addition, in patients with CAD and OSAS, AHI was positively correlated with BMI, LDL, FPG, HOMA-I, and OX-LDL（P 〈 0.05）. Conclusion OSAS increases blood lipid levels and the risks for diabetes in patients with CAD, which may be associated with increased insulin resistance and blood OX-LDL levels.