本文選題：阻塞性睡眠呼吸暫停綜合征 + 2型糖尿病��； 參考：《山西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：測定阻塞性睡民呼吸暫停綜合征(OSAS)患者以及阻塞性睡眠呼吸暫停合并2型糖尿病患者血清中的維生素D的水平,探討維生素D在OSAS引起2型糖尿病中所起的作用以及臨床意義。 方法：74名受試者來自于山西醫(yī)科大學(xué)第二附屬醫(yī)院睡眠監(jiān)測中心、內(nèi)分泌科及體檢中心,根據(jù)中華醫(yī)學(xué)會制定的OSAS診斷標(biāo)準(zhǔn)及2型糖尿病的診斷標(biāo)準(zhǔn),將受試者分為以下四組：健康對照組19名、單純2型糖尿病組14名、OSAS合并2型糖尿病組14名、單純OSAS組27名,并根據(jù)其睡眠呼吸紊亂指數(shù)(AHI)分為輕中重組,其中輕度組9名,中度組8名,重度組10名。所有受試者均記錄性別、年齡、身高、體重、胸圍、腰圍、臀圍、吸煙飲酒史、糖尿病高血.壓家族史,經(jīng)過至少7個小時的多導(dǎo)睡眠監(jiān)測(PSG),次日分析得到呼吸紊亂指數(shù)(AHI)、夜間最低氧飽和度(SaO2min),并于清晨抽取空腹肘部靜脈血,測定空腹血糖(fasting blood glucose FPG)、糖化血紅蛋白(HbAlC)以及血清維生素D的水平。 結(jié)果：(1)與對照組相比,單純2型糖尿病組、OSAS合并糖尿病組、輕中重度OSAS組中的HbAlC、FPG明顯升高,差異具有統(tǒng)計學(xué)意義；重度OSAS組較輕度OSAS組明顯升高,差異具有統(tǒng)計學(xué)意義(P0.05)(2)單純糖尿病組、單純OSAS組、OSAS合并糖尿病組受試者的血清維生素D水平明顯低于對照組,OSAS合并糖尿病組明顯低于單純糖尿病組,差異具有統(tǒng)計學(xué)意義(P0.05)；(3)相關(guān)分析：維生素D與BMI、AHI、糖化血紅蛋白、空腹血糖呈負(fù)相關(guān)(相關(guān)系數(shù)分別為r=-0.309,-0.516,-0.421,-0.458),與最低血氧飽和度呈正相關(guān)(相關(guān)系數(shù)r=0.349)。 結(jié)論：(1)OSAS患者常出現(xiàn)糖代謝紊亂,與AHI、BMI、平均血氧相關(guān)；(2)2型糖尿病患者存在體內(nèi)維生素,D的降低；(3) OSAS患者體內(nèi)維生素D水平較低,可能于其間歇低氧而影響維生素D的吸收與代謝；4)維生素D缺乏可引起糖代謝紊亂,而OSAS患者體內(nèi)低水平的維生素D可能是OSAS引起糖代謝紊亂的原因之一。
[Abstract]:Objective: to determine the serum vitamin D levels in patients with obstructive sleep apnea syndrome (OSAS) and patients with obstructive sleep apnea (OSAS) and type 2 diabetes mellitus. To investigate the role and clinical significance of vitamin D in type 2 diabetes induced by OSAS. Methods Sleep monitoring center, endocrine department and physical examination center of the second affiliated Hospital of Shanxi Medical University were included. According to the diagnostic criteria of OSAS and type 2 diabetes mellitus developed by the Chinese Medical Association. The subjects were divided into the following four groups: healthy control group (n = 19), type 2 diabetes group (n = 14) and OSAS group (n = 27). There were 8 cases in moderate group and 10 cases in severe group. Sex, age, height, weight, chest circumference, waist circumference, hip circumference, smoking and drinking history, diabetes mellitus were recorded in all subjects. After at least 7 hours of polysomnography (PSG), respiratory disturbance index (AHI), nocturnal minimum oxygen saturation (SaO2min) were obtained, and fasting elbow venous blood was drawn in the morning. Fasting blood glucose (fasting blood glucose), glycosylated hemoglobin (HbAlC) and serum vitamin D levels were measured. Results: (1) compared with the control group, the level of HbAlCU FPG in the mild, moderate and severe OSAS group was significantly higher than that in the control group, while that in the severe OSAS group was significantly higher than that in the mild OSAS group, and that in the severe OSAS group was significantly higher than that in the mild OSAS group. The difference was statistically significant (P0.05) (2) the serum vitamin D levels in the OSAS patients with diabetes were significantly lower than those in the control group (P0.05), and the difference was statistically significant (P0.05). (3) correlation analysis: there was a negative correlation between vitamin D and BMIAHI, glycosylated hemoglobin, fasting blood glucose (r = 0.309) and a positive correlation between vitamin D and minimum oxygen saturation (r = 0.349). Conclusion: (1) the disorder of glucose metabolism is often found in OSAS patients, which is related to AHIBMI, mean blood oxygen, (2) the decrease of vitamin D in patients with type 2 diabetes mellitus, and (3) the low level of vitamin D in patients with OSAS. It is possible that vitamin D deficiency may cause glucose metabolism disorder due to intermittent hypoxia. However, low vitamin D level in patients with OSAS may be one of the causes of glucose metabolism disorder caused by OSAS.
【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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