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目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)临床并存率较高的可能原因及机理。方法通过多导睡眠监测将104例习惯性鼾症者分为单纯性鼾症者(对照组)及OSAHS患者, 并根据呼吸暂停低通气指数(AHI)和最低脉氧饱和度(miniSpO2)分别将OSAHS患者进一步分为轻中度及重度OSAHS组。比较MS在各组的发生率。分析多导睡眠监测参数-AHI、miniSpO2、平均脉氧饱和度(meanSpO2);外周循环中代谢参数-空腹血糖(FBG)、总胆固醇(TCH)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、真胰岛素(TI)与胰岛素原(PI)、血压和HOMA指数,以及某些人体测量参数-体重指数(BMI)、腰围及颈围等的相关性。结果所有OSAHS的患者中20%并存有MS。重度OSAHS组的MS发病率明显高于单纯鼾症者的对照组(P <0.05)。Spearman相关分析显示HOMA指数、PI水平均与miniSpO2、meanSpO2呈显著性负相关,但与AHI的相关未达统计学意义;miniSpO2、meanSpO2与BMI、腰围、颈围与舒张压显著性负相关,而与TCH、HLD呈显著性正相关。单因素Logistic回归分析提示HOMA指数与PI是重度OSAHS的危险因素,其OR值(95%可信限)分别为1.926(1.303~2.846)(P<0.01),1.716(1.176~2.505)(P <0.01)。结论对国人鼾症的调查证实OSAHS与MS密切相?
Objective To investigate the possible causes and mechanism of the high coexistence rate of obstructive sleep apnea-hypopnea syndrome (OSAHS) and metabolic syndrome (MS). Methods One hundred and four patients with habitual snoring were divided into simple snoring (control group) and OSAHS patients by polysomnography. According to apnea-hypopnea index (AHI) and minimum spiking oxygen saturation (miniSpO2) OSAHS patients were further divided into mild to moderate and severe OSAHS group. Compare the incidence of MS in each group. The parameters of AHI, miniSpO2 and meanSpO2 were analyzed. The parameters of peripheral circulation such as fasting blood glucose (FBG), total cholesterol (TCH), triglyceride (TG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), true insulin (TI) and proinsulin (PI), blood pressure and HOMA index, as well as some anthropometric parameters such as body mass index (BMI), waist circumference and neck circumference Sex. Results 20% of all OSAHS patients had MS. The incidence of MS in severe OSAHS group was significantly higher than that in simple snoring group (P <0.05). Spearman correlation analysis showed that HOMA index and PI levels were significantly negatively correlated with miniSpO2 and meanSpO2, but not with AHI. There was a significant negative correlation between miniSpO2, meanSpO2 and BMI, waist circumference, neck circumference and diastolic blood pressure There was a significant positive correlation with TCH and HLD. Logistic regression analysis showed that HOMA index and PI were risk factors for severe OSAHS. The OR values (95% confidence limits) were 1.926 (1.303-2.846), 1.716 (1.176-2.505), respectively (P < 0.01). Conclusion The survey of people snoring confirmed that OSAHS closely with MS?