本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + 糖脂代謝��； 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討阻塞性睡眠呼吸暫停低通氣綜合征(Obstructive Sleep Apnea Hypopnea Syndrome,OSAHS)患者糖脂代謝對血液流變學(xué)的影響。方法依據(jù)診斷標(biāo)準(zhǔn),選擇OSHAS患者組70例和同期健康對照組20例,OSAHS患者組分為輕度組17例,中度組25例,重度組28例。入選者均測量身高、體重,計算體重指數(shù)(BMI)。所有受試人員均進(jìn)行多導(dǎo)睡眠監(jiān)測,記錄呼吸暫停低通氣指數(shù)(AHI)、最低血氧飽和度(Minimum oxygen saturation,Min SPO2),測定空腹血糖、血脂、脂聯(lián)素、血液流變學(xué)指標(biāo)。比較OSAHS患者組中各組與對照組空腹血糖、血脂、脂聯(lián)素、血液流變學(xué)等各項指標(biāo)間的差異,并進(jìn)行OSAHS患者組血液流變學(xué)各指標(biāo)與糖脂代謝各指標(biāo)、呼吸暫停低通氣指數(shù)、最低血氧飽和度、體重指數(shù)的相關(guān)性分析。結(jié)果1.OSHAS患者組與對照組比較:血糖、膽固醇、甘油三脂、全血粘度、血漿粘度、全血粘度高切、全血粘度低切、紅細(xì)胞聚集指數(shù)較對照組均升高(P0.05),高密度脂蛋白、脂聯(lián)素、紅細(xì)胞變形指數(shù)較對照組均降低(P0.05)。2.OSHAS患者組中各組與對照組比較:脂聯(lián)素在各組中隨病情加重逐漸降低(P0.05),兩兩比較差異顯著(P0.05);血糖、膽固醇、甘油三脂、全血粘度、血漿粘度、全血還原高切、全血還原低切在OSHAS患者組中隨病情加重逐漸升高(P0.05),輕度組與對照組無差異(P0.05);紅細(xì)胞變形指數(shù)在OSHAS患者組中隨病情加重逐漸降低(P0.05),輕度組與對照組無差異(P0.05);重度組及中度組的高密度脂蛋白較對照組降低(P0.05),重度組降低程度與輕度組相比(P0.05),其余各組比較無差異(P0.05);重度組紅細(xì)胞壓積較中度組、輕度組、對照組升高(P0.05);重度組及中度組的紅細(xì)胞聚集指數(shù)較輕度組、對照組升高(P0.05),重度組與中度組無差異(P0.05)。3.經(jīng)直線相關(guān)分析血液流變學(xué)各指標(biāo)與糖脂代謝各指標(biāo)、AHI、最低血氧飽和度、體重指數(shù)等有不同程度相關(guān)(P0.05)。進(jìn)一步多元線性逐步回歸中,以血液流變學(xué)各指標(biāo)為應(yīng)變量,以糖脂代謝各指標(biāo)、AHI、最低血氧飽和度、體重指數(shù)為自變量,建立回歸方程,從自變量變化中可以推測血液流變學(xué)的特征。結(jié)論OSHAS患者中存在糖脂代謝紊亂和血液流變學(xué)異常:血糖、甘油三脂、膽固醇、全血粘度、血漿粘度、全血粘度高切、全血粘度低切、紅細(xì)胞聚集指數(shù)均升高,與病情嚴(yán)重程度呈正相關(guān),脂聯(lián)素、高密度脂蛋白、紅細(xì)胞變形指數(shù)均降低,與病情嚴(yán)重程度呈負(fù)相關(guān)。經(jīng)相關(guān)分析,糖脂代謝各指標(biāo)與血液流變學(xué)各指標(biāo)顯著相關(guān),糖脂代謝紊亂是血液流變學(xué)發(fā)生改變的原因之一。
[Abstract]:Objective to investigate the effect of glucose and lipid metabolism on hemorheology in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods according to the diagnostic criteria, 70 patients with OSHAS and 20 healthy controls were divided into mild group (n = 17), moderate group (n = 25) and severe group (n = 28). Height and weight were measured and body mass index (BMI) was calculated. All subjects were monitored with polysomnography, apnea hypopnea index (AHIH) and minimum oxygen saturation (MOS) were recorded. Fasting blood glucose, blood lipid, adiponectin and hemorheology were measured. The differences of fasting blood glucose, blood lipid, adiponectin and hemorheology were compared between the OSAHS group and the control group. The indexes of hemorheology, glucose and lipid metabolism, apnea hypopnea index and so on in the OSAHS group were compared. Correlation analysis of minimum oxygen saturation and body mass index. Results the levels of blood glucose, cholesterol, triglyceride, whole blood viscosity, plasma viscosity, whole blood viscosity were high, whole blood viscosity was low, erythrocyte aggregation index (RBC) was higher than control group (P 0.05), high density lipoprotein (HDL), adiponectin (adiponectin). The erythrocyte deformability index was lower than that of the control group (P 0.05) .2.Compared with the control group, adiponectin decreased gradually with the severity of the disease in each group, the difference was significant (P 0.05), the blood glucose, cholesterol, triglyceride, whole blood viscosity, plasma viscosity, blood glucose, cholesterol, triglyceride, whole blood viscosity, plasma viscosity, Whole blood reduced to high shear, In the OSHAS group, the whole blood reduction decreased gradually with the severity of the disease (P0.05), but there was no difference between the mild group and the control group (P0.05). The erythrocyte deformability index decreased gradually with the exacerbation of the disease in the OSHAS group, and there was no difference between the mild group and the control group (P0.05), while in the severe group, the erythrocyte deformability index decreased gradually (P0.05). The high density lipoprotein in the moderate group was lower than that in the control group (P 0.05), the degree of decrease in the severe group was higher than that in the mild group, and the other groups had no difference (P 0.05), and the hematocrit in the severe group was higher than that in the moderate group. The erythrocyte aggregation index of the severe and moderate groups was higher than that of the mild group, while that of the control group was higher than that of the mild group. There was no difference between the severe group and the moderate group. By linear correlation analysis, the hemorheology indexes were correlated with AHI, the lowest oxygen saturation, body mass index and so on. There was a different correlation between the indexes of hemorheology and glycolipid metabolism (P 0.05). In the further multivariate linear stepwise regression, the regression equation was established with the indexes of hemorheology as dependent variables, AHI, minimum oxygen saturation and body mass index as independent variables. The characteristics of hemorheology can be inferred from the variation of independent variables. Conclusion there are hyperglycemia, triglyceride, cholesterol, whole blood viscosity, plasma viscosity, whole blood viscosity high shear, whole blood viscosity low shear and erythrocyte aggregation index increased in patients with OSHAS. Adiponectin, high density lipoprotein and erythrocyte deformability index were positively correlated with the severity of the disease, but negatively correlated with the severity of the disease. By correlation analysis, the indexes of glucose and lipid metabolism were significantly correlated with the indexes of hemorheology, and the disorder of glucose and lipid metabolism was one of the reasons for the change of hemorheology.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R766

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳紹森;鄒林;曾蘊(yùn)湘;胡佩村;;阻塞性睡眠呼吸暫停低通氣綜合征患者血流變及血栓前標(biāo)志物水平的研究[J];實用醫(yī)學(xué)雜志;2016年16期

2 孫明;王國征;徐菲;趙如森;崔玉忠;;高脂血癥患者凝血功能、血小板參數(shù)和血液流變學(xué)檢測的臨床意義[J];中華臨床醫(yī)師雜志(電子版);2013年21期

3 李華;馮振東;葉樹新;李思江;;2型糖尿病患者血液流變學(xué)指標(biāo)與血糖監(jiān)測指標(biāo)的相關(guān)性分析[J];中國全科醫(yī)學(xué);2013年19期

4 楊欣;黃文新;;血液流變學(xué)在心肌梗死診斷、治療和預(yù)后判斷方面的研究進(jìn)展[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2011年16期

5 鄒曉玲;羅湘杭;;脂聯(lián)素研究進(jìn)展[J];實用預(yù)防醫(yī)學(xué);2010年11期

6 周麗媛;王斌全;張芩娜;楊向茹;皇甫輝;夏立軍;;阻塞性睡眠呼吸暫停低通氣綜合征患者血清脂聯(lián)素水平的研究[J];臨床耳鼻咽喉頭頸外科雜志;2010年06期

7 李姍;丁啟龍;;胰島素抵抗大鼠體內(nèi)兒茶酚胺含量變化機(jī)制研究[J];中國臨床藥理學(xué)與治療學(xué);2009年03期

8 孔德磊;康健;王瑋;代兵;蘇新明;;阻塞性睡眠呼吸暫停低通氣綜合征患者嗜睡程度與駕駛車輛能力的關(guān)系研究[J];中國實用內(nèi)科雜志;2008年09期

9 高萍;李五一;神平;黨玉慶;金征宇;;CT和上氣道測壓評估OSAHS舌后區(qū)咽腔狹窄[J];中國醫(yī)學(xué)影像學(xué)雜志;2008年02期

10 王燕;;血液流變學(xué)指標(biāo)與高脂血癥的關(guān)系[J];檢驗醫(yī)學(xué)與臨床;2007年12期

，

本文編號：1898227