噻托溴铵对OSAS患者血糖代谢的影响

Effect of tiotropium bromide on blood glucose metabolism in patients with OSAS

目的探讨抗胆碱能药物噻托溴铵对阻塞性睡眠呼吸暂停综合征(OSAS)患者血糖代谢水平的影响及其临床意义。方法选取2016年6月至2017年6月于华北理工大学附属医院呼吸内科住院的中重度OSAS患者60例为观察组,选择同期门诊正常健康体检者50例为对照组,观察组患者吸入噻托溴铵治疗1个月,测定患者治疗前后空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR),分析其水平变化的意义。结果治疗前,观察组空腹血糖及胰岛素抵抗指数分别为(6.99±0.86)mmol/L、2.8±0.7,对照组为(5.01±0.87)mmol/L、1.2±0.4,两组比较差异有统计学意义(P<0.05)。治疗后,观察组FPG及HOMA-IR分别为(5.21±0.77)mmol/L、1.3±0.5,对照组为(5.01±0.87)mmol/L、1.2±0.4,两组比较差异无统计学意义(P>0.05)。结论 OSAS患者血糖代谢水平明显高于正常健康人群,治疗后其血糖代谢水平可明显降低,提示OSAS患者血糖代谢存在可逆性,且噻托溴铵可有效改善OSAS患者血糖代谢紊乱。

Objective To investigate the effect of anticholinergic drug-tiotropium bromide on blood glucose metabolism in patients with obstructive sleep apnea syndrome(OSAS)and its clinical significance.Methods From June 2016 to June 2017,60 patients with moderate to severe OSAS hospitalized in Department of Respiratory Medicine,Affiliated Hospital of North China University of Technology,were selected as observation group,and 50 patients with normal physical examination in the same period were selected as control group.Observation group was treated with inhalation of tiotropium bromide for one month.The fasting blood glucose(FPG)and insulin resistance index(HOMA-IR)were measured before and after treatment,and the significance of the changes was analyzed.Results Before treatment,the FPG and HOMA-IR in observation group were(6.99±0.86)mmol/L and 1.2±0.4,respectively,while those in control group were(5.01±0.87)mmol/L and 1.2±0.4,respectively,there being significant difference between the two groups(P<0.05).After treatment,the FPG and HOMA-IR in observation group were(5.21±0.77)mmol/L and 1.3±0.5,respectively,while those in control group were(5.01±0.87)mmol/L and 1.2±0.4,respectively,there being no significant difference between the two groups(P>0.05).Conclusion The level of blood glucose metabolism in OSAS patients is significantly higher than that in healthy people.After treatment,the level of blood glucose metabolism can be significantly reduced,suggesting that there is reversibility in blood glucose metabolism of OSAS patients,and tiotropium bromide can effectively improve the disorder of blood glucose metabolism in OSAS patients.