河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (10): 1133-1136.doi: 10.3969/j.issn.1007-3205.2022.10.004

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OSAHS合并糖尿病患者行持续正压通气治疗的临床效果

  

  1. 1.河北省秦皇岛市秦皇岛军工医院呼吸科，河北 秦皇岛 066000；2.河北省秦皇岛市卫生学校药理教研室，
    河北 秦皇岛 066000；3.河北省秦皇岛市秦皇岛军工医院内分泌科，河北 秦皇岛 066000

  • 出版日期:2022-10-25 发布日期:2022-11-16
  • 作者简介:宋涛（1982-），男，河北保定人，河北省秦皇岛市秦皇岛军工医院主治医师，医学学士，从事呼吸疾病诊疗研究。
  • 基金资助:
    秦皇岛市科学技术研究与发展计划（201805A134）

Clinical effect of continuous positive pressure ventilation in the treatment of OSAHS patients with diabetes

  1. 1.Department of Respiratory Diseases, Qinhuangdao Military Hospital of Hebei Province, Qinhuangdao 
    066000, China; 2.Department of Pharmacology, Qinhuangdao Health School, Hebei Province, 
    Qinhuangdao 066000, China; 3.Department of Endocrinology, Qinhuangdao Military 
    Hospital of Hebei Province, Qinhuangdao 066000, China
  • Online:2022-10-25 Published:2022-11-16

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摘要： 目的 采用持续正压通气治疗阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）合并糖尿病患者，分析其对患者血糖及血清巨噬细胞迁移抑制因子（macrophage migrat ioninhibito ryfactor，MIF）的影响。
方法 收集68例OSAHS合并糖尿病患者的临床资料。均对其实施持续正压通气治疗，连续治疗3个月后观察患者空腹血糖、血清MIF等指标改善情况，以讨论持续正压通气治疗的可行性。
结果 治疗3个月后OSAHS合并糖尿病患者的临床总有效率为95.59%（65/68）。相较于治疗前，治疗后患者呼吸暂停低通气（apnea hypopnea index，AHI）指数明显下降，最低血氧饱和度（lowest arterial oxygen saturation，LSpO2）明显上升（P均＜0.05）；相较于治疗前，治疗后患者糖代谢指标、血清MIF等炎症因子水平显著下降（P均＜0.05）；MIF与AHI、空腹血糖呈正相关性（r=0.501、0.457，P均＜0.05），与LSpO2呈负相关性（r=-0.423，P＜0.05）。
结论 持续正压通气治疗OSAHS合并糖尿病患者的疗效理想，能显著改善患者的炎症因子及糖代谢指标。


关键词: 睡眠呼吸暂停,阻塞性, 糖尿病, 持续正压通气

Abstract:

Objective To analyze the effect of continuous positive pressure ventilation(CPPV) on blood glucose and serum macrophage migration inhibitory factor(MIF) in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS) patients with diabetes. 
Methods Clinical data of 68 patients with OSAHS and diabetes were collected. All patients were treated with CPPV. At 3 months after consecutive treatment, the improvement of fasting blood glucose (FBG) and the levels of inflammatory factors including serum MIF were observed to discuss the feasibility of CPPV. 
Results At 3 months after treatment, the total effective rate of OSAHS patients with diabetes was 95.59%(65/68). Compared with that before treatment, the apnea-hypopnea index(AHI) of patients decreased significantly after treatment, and the lowest arterial oxygen saturation(LSpO2) increased significantly(both P＜0.05). Compared with those before treatment, the levels of glucose metabolism indexes, and the levels of inflammatory factors including serum MIF significantly decreased after treatment(all P＜0.05). MIF was positively correlated with AHI and FBG(r=0.501, 0.457, both P＜0.05), and negatively correlated with LSpO2(r=-0.423, P＜0.05). 
Conclusion CPPV has favorable curative effect in the treatment of patients with OSAHS and diabetes, which can significantly improve the inflammatory factors and glucose metabolism indicators of the patients.



Key words: sleep apnea, obstructive, diabetes mellitus, continuous positive pressure ventilation

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