本文選題：睡眠呼吸暫停低通氣綜合征　切入點(diǎn)：2型糖尿病　出處：《山西醫(yī)科大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：1.觀察阻塞性睡眠呼吸暫停低通氣綜合征（obstructive sleep apnea-hypopneasyndrome,OSAHS）及OSAHS合并2型糖尿病（T2DM）患者血清胰島素樣生長因子-1 (IGF-1)、胰淀素（Amylin）水平的變化，并探討它們在OSAHS相關(guān)T2DM發(fā)病中的作用； 2.觀察并討論經(jīng)鼻持續(xù)氣道內(nèi)正壓通氣（nasal-continuous positive airwaypressure,nCPAP）呼吸機(jī)治療對OSAHS合并T2DM患者血清IGF-1、Amylin水平的影響。 方法：1.所有受試對象均進(jìn)行多導(dǎo)睡眠圖監(jiān)測（polysomnography, PSG），并根據(jù)OSAHS和T2DM的診斷標(biāo)準(zhǔn)將受試對象分為單純OSAHS組（簡稱O組）28例，，OSAHS合并T2DM組（簡稱OD組）28例，單純T2DM組（簡稱DM組）28例，另選正常對照組（簡稱N組）28例。用酶聯(lián)免疫吸附法測所有入選者血清IGF-1、Amylin水平。 2.OD組中選取20例依從性較好的患者，經(jīng)nCPAP治療1月后，復(fù)查PSG、空腹血糖（FPG），再次檢測血清IGF-1、Amylin濃度，觀察其變化。 結(jié)果：1.O組、DM組及OD組血清IGF-1水平均較N組降低（P0.01），OD組水平最低，O組、DM組及OD組三組間血清IGF-1水平有顯著性差異（P0.01）；O組、DM組及OD組血清Amylin水平均較N組升高（P0.01），OD組水平最高，O組、DM組及OD組三組間血清Amylin水平亦有顯著性差異（P0.01）。 2.經(jīng)nCPAP治療后OD組患者血清IGF-1水平較治療前升高(P0.01)；Amylin水平較治療前降低(P0.01)。 3.血清IGF-1水平與AHI呈負(fù)相關(guān)（P0.01），與LSaO2及MSaO2呈正相關(guān)（P0.01）；血清Amylin水平與AHI呈正相關(guān)（P0.01），與LSaO2及MSaO2呈負(fù)相關(guān)（P0.01）。 結(jié)論：1.間歇缺氧是引起血清IGF-1水平降低、Amylin水平升高的危險(xiǎn)因素之一； 2.IGF-1、Amylin可作為OSAHS患者血糖升高的預(yù)測因子； 3.nCPAP治療可改善OSAHS合并T2DM患者血清IGF-1、胰淀素、血糖水平，延緩OSAHS所致2型糖尿病的發(fā)生發(fā)展。
[Abstract]:Objective 1. To observe the changes of serum insulin-like growth factor-1 (IGF-1) and amylin (amylin) levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and OSAHS with type 2 diabetes mellitus (T2DM), and to explore their role in the pathogenesis of T2DM. 2. To observe and discuss the effect of nasal-continuous positive airway pressure pressure (CPAP) ventilator therapy on serum IGF-1Amylin level in patients with OSAHS complicated with T2DM. Methods: all subjects were monitored by polysomnography (PSG) by polysomnography. According to the diagnostic criteria of OSAHS and T2DM, the subjects were divided into two groups: OSAHS group (n = 28), OSAHS with T2DM group (n = 28) and T2DM group (n = 28). The serum levels of IGF-1 Amylin were measured by enzyme-linked immunosorbent assay (Elisa) in 28 normal controls (n = 28). 2.Twenty patients with good compliance were selected in OD group. After treatment with nCPAP on January, the levels of IGF-1 and Amylin in serum were determined again. Results 1. Serum IGF-1 levels in DM group and OD group were significantly lower than those in N group. The serum IGF-1 levels in DM group and OD group were significantly lower than those in N group. The serum Amylin levels in DM group and OD group were higher than those in N group. There was also a significant difference in serum Amylin levels between DM group and OD group (P 0.01). 2.The level of serum IGF-1 in OD group after nCPAP treatment was higher than that before treatment. The level of P0.01Amylin in OD group was lower than that before treatment. 3. Serum IGF-1 level was negatively correlated with AHI (P 0.01), positively correlated with LSaO2 and MSaO2 (P 0.01), serum Amylin with AHI (P 0.01), LSaO2 and MSaO2 with negative correlation (P 0.01). Conclusion 1. Intermittent hypoxia is one of the risk factors to decrease the level of serum IGF-1 and increase the level of amylin. 2. IGF-1Amylin can be used as a predictor of hyperglycemia in patients with OSAHS. 3. NCPAP can improve the level of serum IGF-1, amylin and blood glucose in patients with OSAHS and T2DM, and delay the development of type 2 diabetes caused by OSAHS.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R56;R587.1

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