2型糖尿病睡眠障碍患者脑血流动力学研究

Study on cerebral hemodynamics in type 2 diabetes mellitus patients with sleep disorders

目的探讨2型糖尿病(T2DM)睡眠障碍患者脑血流动力学变化。方法选择2021年1月至12月期间收治的2型糖尿病患者162例,根据匹兹堡睡眠质量指数(PSQI)将患者分为无睡眠障碍组83例(PSQI评分≤7分)和睡眠障碍组79例(PSQI评分>7分),测量体重指数、血压、空腹血糖(FBG)、空腹胰岛素(FGS)、糖化血红蛋白(HbA1c)、血脂、同型半胱氨酸等代谢指标水平。两组均予经颅多普勒超声仪检测颅内血流情况,记录并比较大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、颈内动脉终末端(ICA)、椎动脉(VA)和基底动脉(BA)的平均血流速度。结果睡眠障碍组T2DM病程长于无睡眠障碍组(P<0.05),收缩压、HbA1c高于无睡眠障碍组(P<0.05)。睡眠障碍组MCA、ACA和ICA平均血流速度较无睡眠障碍组低(P<0.05),PCA、VA和BA平均血流速度与无睡眠障碍组比较差异无统计学意义(P>0.05)。结论2型糖尿病睡眠障碍患者脑血流平均速度减慢,脑供血减少,改善睡眠质量有利于控制血糖血压,有利于改善脑供血情况。

Objective To investigate the changes of cerebral hemodynamics in type 2 diabetes mellitus(T2DM)patients with sleep disorders.Methods 162 T2DM patients with sleep disorders admitted in Liuzhou Hospital of Traditional Chinese Medicine from January to December,2021 were selected and divided into the group with sleep disorders(83 cases)and the one without sleep disorders(79 cases)according to the Pittsburgh sleep quality index(PSQI).All patients'metabolic indicators including body mass index,blood pressure,fasting blood glucose(FBG),fasting insulin(FGS),glycosylated hemoglobin(HbA1c),blood lipids,and homocysteine,etc.were measured;intracranial blood flow in both groups was detected by transcranial Doppler ultrasound,and the mean blood flow velocities of middle cerebral artery(MCA),anterior cerebral artery(ACA),posterior cerebral artery(PCA),terminal internal carotid artery(ICA),vertebral artery(VA)and basilar artery(BA)were recorded and compared between the two groups.Results The disease course of the group with sleep disorders was longer than that without sleep disorders(P<0.05),and the systolic blood pressure and HbA1c of the group with sleep disorders were higher than those in group without sleep disorder(P<0.05).The mean blood flow velocities in MCA,ACA,and ICA in the group with sleep disorders were slower than those in the group without sleep disorders(P<0.05).There was no statistically significant difference in the mean blood flow velocities in PCA,VA,and BA between the two groups(P>0.05).Conclusion The mean velocity of cerebral blood flow in T2DM patients with sleep disorders decreases with cerebral blood supply reduced;improving sleep quality is conducive to blood glucose and blood pressure control and helpful in improving cerebral blood supply.