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目的探讨持续正压通气(nCPAP)对2型糖尿病(T2DM)合并重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆尾加压素(U-II)的影响及其病理生理学的临床意义。方法采用整夜多导睡眠检测(PSG)并手动(nCPAP)压力滴定治疗T2DM合并重度OSAHS患者30例;放射免疫法测定治疗前后患者血浆中U-II的水平;采血测定治疗前后空腹血糖(FPG)水平。结果治疗前患者血浆U-II的水平(9.87±1.14)pg/ml,治疗后为(6.89±1.02)pg/ml,治疗前后差异有统计学意义(P<0.01);治疗前后FPG分别为(11.6±1.4)mmol/L和(7.3±2.0)mmol/L,差异有统计学意义(P<0.01);治疗前后氧饱和度(SpO2)分别为(60.8±15.2)%和(83.8±4.7)%,差异有统计学意义(P<0.01);治疗前后呼吸紊乱指数(AHI)分别为(52.2±20.4)次/h和(15.3±3.5)次/h,差异有统计学意义(P<0.01)。结论 U-II的增高可能是T2DM合并DSAHS患者疾病发生、发展的重要因素,通过nCPAP治疗可使患者血浆中血浆U-II水平明显降低,血糖明显下降,SPO2改善,具有显著的临床疗效。
Objective To investigate the effect of continuous positive pressure ventilation (nCPAP) on plasma urotensin (U-II) in patients with type 2 diabetes mellitus (T2DM) complicated with severe obstructive sleep apnea-hypopnea syndrome (OSAHS) and its clinical significance . Methods Thirty patients with T2DM and severe OSAHS were treated with overnight polysomnography (PSG) and manual pressure (nCPAP) titration. The levels of U-II in plasma were measured by radioimmunoassay before and after treatment. The levels of fasting plasma glucose (FPG) )Level. Results Before treatment, the level of U-II in plasma was (9.87 ± 1.14) pg / ml and (6.89 ± 1.02) pg / ml after treatment, and the difference was statistically significant before and after treatment (P <0.01) (P <0.01); the oxygen saturation (SpO2) before and after treatment were (60.8 ± 15.2)% and (83.8 ± 4.7)%, respectively %, The difference was statistically significant (P <0.01). Before and after treatment, the AHI values were (52.2 ± 20.4) / h and (15.3 ± 3.5) h / h, respectively, with significant difference ). Conclusions U-II elevation may be an important factor in the occurrence and development of disease in patients with T2DM complicated with DSAHS. The nCPAP treatment can significantly decrease the plasma U-II level, decrease the blood glucose and improve the SPO2 in patients with DSAHS.