持续正压通气对OSAHS合并2型糖尿病患者睡眠、糖代谢及氧化应激的影响

Effect of continuous positive airway pressure treatment on sleep,glycometabolism and oxidative stress in patients with obstructive sleep apnea hypopnea syndrome and type 2 diabetes mellitus

目的探讨持续正压通气(CPAP)对睡眠呼吸暂停低通气综合征(OSAHS)合并2型糖尿病(T2DM)患者睡眠、糖代谢及氧化应激的影响。方法将我院呼吸内科收治的OSAHS合并T2DM患者110例随机分为CPAP组和对照组,各55例。所有患者均按原糖尿病方案治疗,CPAP组在此基础上采用经鼻面罩CPAP治疗2周。比较两组患者的睡眠质量、糖代谢指标及氧化应激反应的变化。结果治疗后,CPAP组患者的AHI明显降低,最长睡眠呼吸暂停时间缩短,SaO_2明显升高,且均显著优于对照组(P<0.05)。治疗后,CPAP组FBG、Hb A1C及HOMA-IR均较治疗前明显下降,且明显低于对照组(P<0.05)。治疗后,CPAP组MDA含量显著升高,而SOD、GSH-PX水平则明显降低(P<0.05)。结论 CPAP治疗OSAHS合并T2DM患者可纠正夜间缺氧,提高睡眠质量,改善糖代谢及氧化应激反应。

Objective To explore the clinical effect of continuous positive airway pressure （ CPAP） treat-ment on sleep, glycometabolism and oxidative stress in patients with obstructive sleep apnea hypopnea syndrome （ OS-AHS） and type 2 diabetes mellitus （T2DM）. Methods 110 patients with OSAHS and T2DM who received treat-ment in the department of respiratory medicine in our hospital were randomly and equally divided into two groups. All the patients were treated by original diabetes treatment plan. On this basis, the CPAP group （n=55） was given na-sal CPAP additionally. The change of sleep quality, glycometabolism and oxidative stress between the two groups were compared. Results After treatment, the AHI reduced, the longest sleep apnea time shortened, and SaO2 increased obviously in the CPAP group, which were all significantly better than those of the control group （P〈0. 05）. Com-pared with before treatment, the level of FBG, HbA1C and HOMA-IR in the CPAP group decreased obviously after treatment, and significantly lower than those of the control group （P〈0. 05）. After treatment, the CPAP group had a significant rise of the content of MDA, decrease of the levels of SOD and GSH-PX （ P〈0. 05 ） . Conclusion CPAP for the treatment of OSAHS and T2DM can contribute to correct hypoxia at night, improve sleep quality, im-prove glucose metabolism and oxidative stress.