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目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并阻塞性睡眠呼吸暂停综合症(obstructive sleep apnea syndrome,OSAS)患者血清炎性因子及相关因素。方法选取常山县人民医院2012年1月-2014年12月期间就诊的患者为研究对象,根据OSAS和T2DM的诊断标准将研究对象分为3组:OSAS合并T2DM组(OD组)、单纯OSAS组(O组)、单纯T2DM组(D组),同时另选体检科参加体检的78例健康人群作为对照组(N组),使用多导睡眠监测仪调查患者睡眠呼吸情况,并对血糖、糖化血红蛋白(Hb A1c)及血清中IL-6、IL-8、hs-CRP、TNF-α、ICAM-1的水平进行检测,并观察T2DM合并OSAS患者经n CPAP治疗后的各指标的变化,以分析OSAS合并T2DM患者血清炎性因子的变化及相关因素。结果各组研究对象性别、年龄差异均无统计学意义(均P>0.05),OD组患者BMI、HbA1c、FPG、AHI、LSa O2、MSa O2与其他三组相比较差异均有统计学意义(均P<0.05);OD组患者血清各炎性因子水平均明显高于N组、O组、D组(均P<0.05);经相关分析发现,IL-6、hs-CRP均与Hb A1c、FPG、AHI呈正相关(均P<0.05);经nCPAP治疗后,OD组患者血清中各炎性因子水平明显降低,差异均有统计学意义(均P<0.05)。结论 T2DM合并OSAS患者炎性因子水平较高,且与HbA1c、FPG、AHI呈相关性,因此这一炎症过程可能诱发和加重T2DM合并OSAS的重要调控机制之一。
Objective To investigate the serum inflammatory factors and its related factors in type 2 diabetes mellitus (T2DM) patients with obstructive sleep apnea syndrome (OSAS). Methods Patients from Changshan County People’s Hospital from January 2012 to December 2014 were selected as study subjects. Subjects were divided into three groups according to diagnostic criteria of OSAS and T2DM: OSAS combined with T2DM group (OD group), OSAS group alone (Group O) and simple T2DM group (group D). At the same time, 78 healthy subjects who participated in the physical examination as the control group were selected as the control group (N group). The polysomnography was used to investigate the sleep apnea and blood glucose, The levels of Hb A1c, IL-6, IL-8, hs-CRP, TNF-α and ICAM-1 in serum were detected and the change of each index after treatment with nCPAP in T2DM patients with OSAS To analyze the changes of serum inflammatory factors in OSAS combined with T2DM and related factors. Results There were no significant differences in gender and age between the two groups (all P> 0.05). There were significant differences in BMI, HbA1c, FPG, AHI, LSa O2 and MSa O2 among the three groups (All P <0.05). The levels of serum inflammatory cytokines in OD patients were significantly higher than those in N, O and D groups (all P <0.05). Correlation analysis showed that the levels of IL-6 and hs- , FPG and AHI (all P <0.05). After nCPAP treatment, the levels of serum inflammatory cytokines in OD patients were significantly decreased (all P <0.05). Conclusions The levels of inflammatory cytokines in patients with T2DM complicated with OSAS are high, and are correlated with HbA1c, FPG and AHI. Therefore, this inflammatory process may induce or aggravate one of the important regulatory mechanisms of T2DM with OSAS.