持续气道正压通气对阻塞性睡眠呼吸暂停综合征患者糖化血红蛋白水平的影响

Effect of continuous positive airway pressure on glycosylated hemoglobin levels in patients with obstructive sleep apnea syndrome

目的 观察阻塞性睡眠呼吸暂停综合征（OSAHS）患者糖化血红蛋白（HbA1c）水平的变化,评估持续气道正压通气（CPAP）对OSAHS患者HbA1c水平的影响。方法 选择2013年1月-2016年12月诊治的OSAHS患者80例,按照睡眠呼吸暂停低通气指数（AHI）不同分为轻度组18例,中度组20例,重度组42例。择30例健康体检者为对照组。所有治疗组行CPAP治疗3个月,治疗前后均行过夜多导睡眠监测和HbA1c检测。对照组在治疗前行HbA1c检测。结果 中、重度组糖化血红蛋白水平明显比对照组高（P〈0.05）。治疗后,中、重度组糖化血红蛋白水平明显降低（P〈0.05）,且其睡眠呼吸暂停低通气指数、最低Sa O2、平均Sa O2水平均明显改善（P〈0.01）。结论 中、重度OSAHS患者糖化血红蛋白明显升高,经CPAP治疗后可以降低中、重度OSAHS患者糖化血红蛋白水平。

Objective To observe the effect of obstructive sleep apnea syndrome （OSAHS） patients with glycosylated hemoglobin （HbA1c） levels, assessment of continuous positive airway pressure （CPAP） effect on the level of HbA1c in patients with OSAHS. Methods From January 2013 to December 2016, eighty patients with OSAHS were divided into mild group, eighteen cases, moderate group twenty cases, severe group forty-two cases according to the apnea hypopnea index （AHI）. Thirty healthy subjects were chosen as the control group. All the treatment groups were treated with CPAP for three months. Overnight polysomnography and HbA1c test were performed before and after treatment, and the control group was examined by HbA1c before treatment. Results The level of glycosylated hemoglobin in the middle and severe group was higher than that of the control group（P〈0.05）. After treatment, the glycated hemoglobin levels in the moderate and severe groups were significantly lower（P〈0.05）, and the sleep apnea hypopnea index, the lowest SaO2 and the average SaO2 level were significantly improved（P〈0.01）. Conclusion Glycated hemoglobin levels increased significantly in patients with moderate and severe OSAHS, and decreased HbA1c levels in patients with moderate and severe OSAHS after CPAP treatment.