[1]刘凯坤,袁慧娟#,袁倩,等.CPAP治疗对2型糖尿病合并OSAHS患者糖尿病临床控制的作用[J].郑州大学学报(医学版),2015,(04):532-535.
 LIU Kaikun,YUAN Huijuan,YUAN Qian,et al.Effect of CPAP on clinical control of diabetes in patients with OSAHS and type 2 diabetes mellitus[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2015,(04):532-535.
点击复制

CPAP治疗对2型糖尿病合并OSAHS患者糖尿病临床控制的作用()
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2015年04期
页码:
532-535
栏目:
应用研究
出版日期:
2015-07-20

文章信息/Info

Title:
Effect of CPAP on clinical control of diabetes in patients with OSAHS and type 2 diabetes mellitus
作者:
刘凯坤1袁慧娟2#袁倩2虎子颖2史晓阳2张会峰2赵志刚2
1)郑州大学附属郑州中心医院内分泌科 郑州 4500002)河南省人民医院内分泌科 郑州 450003
Author(s):
LIU Kaikun1YUAN Huijuan2YUAN Qian2 HU Ziying2 SHI Xiaoyang2 ZHANG Huifeng2 ZHAO Zhigang2
1)Department of Endocrinology, the Affiliated Zhengzhou Central Hospital, Zhengzhou University, Zhengzhou 4500002)Department of Endocrinology, Henan Provincial People′s Hospital, Zhengzhou 450003
关键词:
糖尿病2型睡眠呼吸暂停阻塞性持续气道正压通气血糖
Keywords:
diabetes mellitustype 2sleep apneaobstructivecontinuous positive airway pressureblood glucose
分类号:
R587.1
文献标志码:
A
摘要:
要目的:评价持续气道正压通气(CPAP)治疗对2型糖尿病(T2DM)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者糖尿病临床控制的作用。方法:收集T2DM合并OSAHS住院患者53例,给予动态血糖监测、多导睡眠图监测,53例接受短期CPAP治疗(持续1晚),17例接受长期CPAP治疗(3个月);CPAP治疗前后测定空腹血糖、胰岛素、糖化血红蛋白(HbA1c),计算稳态模型胰岛素抵抗指数(HOMAIR)。另选取单纯T2DM患者30例,2组患者于确诊次日测定空腹及餐后1 h胰高血糖素1(GLP1),计算ΔGLP1。结果:T2DM合并OSAHS患者短期CPAP治疗后,夜间血糖、平均血糖波动幅度及HOMAIR均降低(t配对=2.800、3.132和4.344,P<0.05);长期CPAP治疗后,HbA1c与HOMAIR降低(t配对=3.733、3.329,P<0.05)。T2DM合并OSAHS组患者ΔGLP1较单纯T2DM组患者降低(t=2.265,P=0.026)。结论:T2DM合并OSAHS患者CPAP治疗后糖尿病得到临床控制;OSAHS可能影响患者GLP1的分泌。
Abstract:
Aim: To explore the effect of continuous positive airway pressure(CPAP) treatment on clinical control of diabetes in patients with OSAHS and type 2 diabetes mellitus. Methods: Fiftythree patients with OSAHS and type 2 diabetes mellitus were recruited,among whom,53 accepted shortterm CPAP treatment,and 17 accepted longterm CPAP treatment. Continuous glucose monitoring system, polysomnographic monitoring and CPAP treatment were applied. Fasting glucose, insulin and HbA1c were measured before and after CPAP. Another 30 patients with type 2 diabetes mellitus were collected and the fasting GLP1 and 1 h postprandial GLP1 of the patients in the 2 groups were determined,and ΔGLP1 was calculated.Results: After shortterm CPAP treatment, nocturnal blood glucose, MAGE and HOMAIR in patients with OSAHS and type 2 diabetes mellitus were lower than those before treatment(tpaired=2.800,3.132 and 4.344,P<0.05). After 3 month CPAP treatment, HbA1c and HOMAIR were lower than those before treatment(tpaired=3.733 and 3.329,P<0.05). The ΔGLP1 in patients with OSAHS and type 2 diabetes mellitus was lower than that in patients with type 2 diabetes mellitus(t=2.265,P=0.026).Conclusion: After CPAP treatment, the diabetic indexes of patients with OSAHS and type 2 diabetes mellitus are under control and OSAHS may affect the secretion of GLP1.

参考文献/References:

[1]West SD,Nicoll DJ,Stradling JR.Prevalence of obstructive sleep apnoea in men with type 2 diabetes[J].Thorax,2006,61(11):945
[2]Einhorn D,Stewart DA,Erman MK,et al.Prevalence of sleep apnea in a population of adults with type 2 diabetes mellitus[J].Endocr Pract,2007,13(4):355
[3]Harsch IA,Schahin SP,RadespielTrger M,et al.Continuous positive airway pressure treatment rapidly improves insulin sensitivity in patients with obstructive sleep apnea syndrome[J].Am J Respir Crit Care Med,2004,169(2):156
[4]Katsumata K,Okada T,Miyao M,et al.High incidence of sleep apnea syndrome in a male diabetic population[J].Diabetes Res Clin Pract,1991,13(1/2):45
[5]Babu AR,Herdegen J,Fogelfeld L,et al.Type 2 diabetes,glycemic control,and continuous positive airway pressure in obstructive sleep apnea[J].Arch Intern Med,2005,165(4):447
[6]Harsch IA,Schahin SP,Brückner K,et al.The effect of continuous positive airway pressure treatment on insulin sensitivity in patients with obstructive sleep apnoea syndrome and type 2 diabetes[J].Respiration,2004,71(3):252
[7]Czupryniak L,Loba J,Pawlowski M,et al.Treatment with continuous positive airway pressure may affect blood glucose levels in nondiabetic patients with obstructive sleep apnea syndrome[J].Sleep,2005,28(5):601
[8]Steiropoulos P,Papanas N,Nena E,et al. Markers of glycemic control and insulin resistance in nondiabetic patients with Obstructive Sleep Apnea Hypopnea Syndrome:does adherence to CPAP treatment improve glycemic control? [J].Sleep Med,2009,10(8):887
[9]Smurra M,Philip P,Taillard J,et al.CPAP treatment does not affect glucoseinsulin metabolism in sleep apneic patients [J].Sleep Med,2001,2(3):207
[10]Leuenberger U,Jacob E,Sweer L,et al.Surges of muscle sympathetic nerve activity during obstructive apnea are linked to hypoxemia[J].J Appl Physiol,1995,79(2):581
[11]Smith ML,Niedermaier ON,Hardy SM,et al.Role of hypoxemia in sleep apneainduced sympathoexcitation[J].J Auton Nerv Syst,1996,56(3):184
[12]Spiegel K,Leproult R,Van Cauter E.Impact of sleep debt on metabolic and endocrine function[J].Lancet,1999,354(9188):1435
[13]Lugari R, Dei Cas A, Ugolotti D, et al. Evidence for early impairment of glucagonlike peptide 1 induced insulin secretion in human type 2(non insulindependent) diabetes[J].Horm Metab Res,2002,34(3):150
[14]Cheng N, Cai W, Jiang M, et al. Effect of hypoxia on blood glucose, hormones, and insulin receptor functions in newborn calves[J].Pediatr Res,1997,41(6):852

相似文献/References:

[1]张雷),张书芳),胡东生),等.河南省居民营养与健康状况调查[J].郑州大学学报(医学版),2010,(01):124.
 ZHANG Lei),ZHANG Shufang),HU Dongsheng),et al.Nutrition and health status survey in Henan Province[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(04):124.
[2]张东铭),张苏河)#,徐占稳),等.糖尿病大鼠心肌梗死后非梗死区心肌细胞凋亡和增殖检测[J].郑州大学学报(医学版),2010,(02):259.
 ZHANG Dongming),ZHANG Suhe),XU Zhanwen),et al.Study of apoptosis and proliferation of myocardium in noninfrarction area after myocardial infraction of rat model of diabetes mellitus[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(04):259.
[3]赵先兰△,袁瑞珍,孙亚兰,等.妊娠合并糖尿病对母儿的影响[J].郑州大学学报(医学版),2010,(02):330.
[4]沈全明,韩新光,崔文光,等.口腔颌面部严重感染合并糖尿病29例治疗体会[J].郑州大学学报(医学版),2010,(02):349.
[5]孟建波)△,康胜群),康素娴),等.骨髓干细胞移植治疗糖尿病兔下肢缺血效果观察*[J].郑州大学学报(医学版),2009,(06):1168.
 MENG Jianbo),KANG Shengqun),KANG Suxian),et al.Effect of transplantation of autologous bone marrow stem cell on diabetic lowe limb ischemia of rabbits[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(04):1168.
[6]郝燕燕△,付蓉花,卢振威,等.α硫辛酸对早期糖尿病性视网膜病变大鼠视网膜组织血管内皮生长因子和蛋白激酶C表达的影响[J].郑州大学学报(医学版),2009,(06):1201.
 HAO Yanyan,FU Ronghua,LU Zhenwei,et al.Effects of αlipoic acid on expression of VEGF and protein rinase C in retinal tissue from rats with earlier period diabetic retinopathy[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(04):1201.
[7]苟建军,张水军,郭文治.胰肾联合移植并发症的处理[J].郑州大学学报(医学版),2009,(05):1091.
[8]杨五彪△,席守民,马灵筠,等.Avandamet对糖尿病小型猪胰岛β细胞及糖代谢的影响*[J].郑州大学学报(医学版),2009,(04):744.
 YANG Wubiao,XI Shoumin,MA Lingjun,et al.Effect of Avandamet on islet β cells in diabetic miniature pigs[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(04):744.
[9]张峰),曾秋棠)#,李宾公),等.非诺贝特对糖尿病性心肌病大鼠心肌炎症和心室重塑的影响[J].郑州大学学报(医学版),2009,(01):136.
 ZHANG Feng),ZENG Qiutang),LI Bingong),et al.Effects of fenofibrate on myocardial inflammation and ventricular remodeling of diabetic cardiomyopathy rats[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(04):136.
[10]吴文迅)),刘东伟),刘章锁)#,等.郑州市成年人血糖异常分布与慢性肾脏病的关系调查*[J].郑州大学学报(医学版),2009,(03):550.
 WU Wenxun)),LIU Dongwei),LIU Zhangsuo),et al.Investigation of pathoglycemia distribution and chronic kidney disease among adults in Zhengzhou city[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2009,(04):550.
[11]张丽侠,郑丽丽#,阎西艴,等.强化降糖对2型糖尿病血管并发症的影响[J].郑州大学学报(医学版),2010,(02):296.
 ZHANG Lixia,ZHENG Lili,YAN Xifu,et al.Effects of intensive glucose control on angiopathy complication of patients with type 2 diabetes[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2010,(04):296.

更新日期/Last Update: 1900-01-01