老年阻塞性睡眠呼吸暂停低通气综合征伴2型糖尿病病人炎症反应及睡眠质量研究

Study on the inflammatory reaction and sleep quality in elderly patients with OSAHS complicated with type 2 diabetes mellitus

目的:探讨老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴2型糖尿病病人炎症反应及睡眠质量特点,为临床干预提供依据。方法:选取经多导睡眠监测及空腹血糖检测确诊的OSAHS伴2型糖尿病病人78例,单纯OSAHS病人37例。所有病人采用酶联免疫吸附法测定血清白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平;采用疲劳严重程度量表(FSS)和Epworth嗜睡量表(ESS)评价睡眠质量。比较2组血清指标及量表评分变化。结果:与单纯OSAHS组病人比较,老年OSAHS伴2型糖尿病组睡眠中平均每小时呼吸暂停+低通气指数(AHI)、IL-6、TNF-α、FSS和ESS得分均明显增高(P<0.01);老年OSAHS伴2型糖尿病病人IL-6、TNF-α与AHI呈正相关关系(P<0.05),与SpO2呈负相关(P<0.05)。结论:与单纯OSAHS病人比较,老年OSAHS伴2型糖尿病病人全身炎症反应更为显著,睡眠质量及睡眠紊乱更明显,血清IL-6、TNF-α水平与睡眠紊乱严重程度相关。

Objective:To investigate the characteristics of inflammatory reaction and sleep quality in elderly patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)complicated with type 2 diabetes mellitus,and provide theoretical basis for clinical intervention.Methods:The serum ievels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in 78 OSAHS complicated with type 2 diabetes mellitus patients diagnosed by polysomnography(PSG)combnined with fasting glucose,and 37 patients with OSAHS were detected using enzyme-linked immunosorbent assay(ELISA).The sleep quality in all cases was evaluted using fatigue severity scale(FSS)and Epworth sleepiness scale(ESS).The serum levels of indicators and scale scores were compared between two groups.Results:Compared with the simple OSAHS group,the AHI,serum levels of IL-6 and TNF-αand scores of FSS and ESS in OSAHS complicated with type 2 diabetes mellitus group significantly increased(P<0.01).The serum levels of IL-6 and TNF-αwere positively correlated with AHI(P<0.05),and negatively correlated with SpO2(P<0.05).Conclusions:Compared with the simple OSAHS patients,the systemic inflammatory response and sleep disorders in elderly patients with OSAHS complicated with type 2 diabetes mellitus are more significant,and the serum levels of IL-6 and TNF-αare associated with the severity of sleep disorders.