本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + 年齡　； 參考：《南方醫(yī)科大學(xué)》2015年碩士論文

【摘要】：研究背景阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea hypopnea syndrome, OSAHS)是國際公認(rèn)的主要公共衛(wèi)生問題之一,是一種睡眠由口咽部塌陷、咽腔狹窄等導(dǎo)致上氣道反復(fù)堵塞而反復(fù)出現(xiàn)呼吸暫停和(或)低通氣,引起間歇性缺氧、睡眠片段化、高碳酸血癥等,從而使機(jī)體發(fā)生一系列病理生理改變的臨床綜合征,主要表現(xiàn)是睡眠打鼾、呼吸暫停、晨起口干,睡眠不解乏,白日嗜睡,夜尿增多等癥狀,可引起自主神經(jīng)及內(nèi)分泌紊亂,產(chǎn)生炎癥反應(yīng),損傷組織、多器官,與多系統(tǒng)疾病相關(guān),如高血壓、腦卒中、心律失常、心絞痛等,嚴(yán)重影響人們的身心健康,若治療不及時(shí),可危及生命。OSAHS患者普遍存在,成年人OSAHS患病率男性高達(dá)4%,女性高達(dá)2%。據(jù)研究,OSAHS患者的年平均醫(yī)療費(fèi)用比健康對照組顯著增高,而且OSAHS的嚴(yán)重程度與醫(yī)療費(fèi)用呈正相關(guān)。除了醫(yī)療費(fèi)用,OSAHS導(dǎo)致的經(jīng)濟(jì)損失,還包括工傷、機(jī)動(dòng)車交通事故、生產(chǎn)量下降等產(chǎn)生的費(fèi)用。OSAHS患者發(fā)生工傷事故的風(fēng)險(xiǎn)是對照組的2.2倍,造成機(jī)動(dòng)車交通事故的風(fēng)險(xiǎn)是對照組的3-7倍。人有三分之一的時(shí)間在睡眠,人們的生長發(fā)育、體力恢復(fù)等多在睡眠中完成,長期低質(zhì)量睡眠會(huì)使人注意力不集中,脾氣暴躁,攻擊性強(qiáng),精神疲勞,記憶力減退,抵抗力下降,內(nèi)分泌紊亂,也可誘發(fā)冠心病、高血壓、腦卒中、月經(jīng)失調(diào)等疾病。睡眠質(zhì)量的好壞與人們的身體健康、生活質(zhì)量密切相關(guān)。而OSAHS是睡眠障礙的疾病之一,OSAHS患者可出現(xiàn)微覺醒增加,睡眠片段化,導(dǎo)致白日嗜睡。而年齡亦是影響睡眠的因素之一,研究發(fā)現(xiàn)不同年齡段的睡眠質(zhì)量不一樣,老年人更容易出現(xiàn)入睡困難、睡眠時(shí)間縮短,易醒、早醒。而且年齡與OSAHS的發(fā)生發(fā)展相關(guān)。但是,OSAHS和年齡各自對患者睡眠結(jié)構(gòu)影響的研究尚缺乏,大多數(shù)對OSAHS患者睡眠結(jié)構(gòu)的研究忽略了年齡對睡眠結(jié)構(gòu)的影響,而研究各年齡組的OSAHS患者睡眠結(jié)構(gòu)特點(diǎn)未排除OSAHS對睡眠結(jié)構(gòu)的影響。OSAHS患者得到及時(shí)準(zhǔn)確的診斷和治療,不但可以預(yù)防或控制心腦血管疾病、代謝性疾病等疾病的發(fā)生與發(fā)展,而且可以減少衛(wèi)生資源的消耗,提高OSAHS患者的生活質(zhì)量,提升幸福指數(shù)。OSAHS診斷的金標(biāo)準(zhǔn)是多導(dǎo)睡眠監(jiān)測(polysomnography, PSG),首選治療方法是經(jīng)鼻持續(xù)氣道正壓通氣(continuous positive airway pressure, CPAP), CPAP治療成功的關(guān)鍵因素之一是設(shè)定合適的治療壓力,測定最佳治療壓力的標(biāo)準(zhǔn)方法是人工氣道壓力滴定試驗(yàn)。設(shè)定合適的CPAP治療壓力可提高治療的舒適性及有效性,提高患者的依從性。而OSAHS患者長期CPAP治療后治療壓力和睡眠結(jié)構(gòu)的變化尚未明確,相關(guān)的研究尚缺乏,尤其是在發(fā)布2007年版新的AASM判讀手冊后�，F(xiàn)有的文獻(xiàn)大多數(shù)只研究了OSAHS患者初始CPAP治療后睡眠結(jié)構(gòu)和低氧血癥的變化,缺乏對長期CPAP治療的效果及壓力變化的研究。糖尿病亦是重大公共衛(wèi)生問題之一,在中國,糖尿病的患病率為9.7%,糖尿病前期為15.5%。據(jù)研究,每年由糖尿病產(chǎn)生的直接和間接醫(yī)療費(fèi)用高達(dá)1740億美元,且每年導(dǎo)致近25萬人死亡。但只有23.66%的患者意識(shí)到自己的糖尿病。心血管疾病是2型糖尿病的主要致死因素,此外,糖尿病還可損害眼睛、腎及神經(jīng)系統(tǒng)等。OSAHS與糖尿病的關(guān)系已成為研究熱點(diǎn)。有研究統(tǒng)計(jì),在OSAHS患者中,2型糖尿病的患病率在15%-30%之間,糖尿病前期在20%-67%之間。然而,部分研究卻未發(fā)現(xiàn)OSAHS與糖代謝紊亂獨(dú)立相關(guān)。OSAHS的兩大特征是慢性間歇性低氧血癥和睡眠片段化,而兩者與血糖代謝的關(guān)系如何尚缺乏綜合研究。經(jīng)鼻持續(xù)氣道正壓通氣(continuous positive airway pressure, CPAP)能夠有效的降低呼吸暫停低通氣指數(shù),改善低氧血癥,提高患者的睡眠質(zhì)量,改善患者的嗜睡、認(rèn)知功能障礙,提高生活質(zhì)量。據(jù)研究CPAP治療可以降低合并高血壓的OSAHS患者的血壓,減少心腦血管疾病的發(fā)生,改善心律失常,增強(qiáng)心功能；但是OSAHS患者CPAP治療后血糖代謝是否改善仍存在爭議,而且,我國對OSAHS患者CPAP治療1月后血糖如何改變尚缺乏研究。以下我們將研究OSAHS患者Auto-CPAP治療1月前后睡眠結(jié)構(gòu)、治療壓力、血糖代謝的特點(diǎn)。第一章阻塞性睡眠呼吸暫停低通氣綜合征患者CPAP治療1月前后睡眠結(jié)構(gòu)及治療壓力的變化目的：綜合分析阻塞性睡眠呼吸暫停低通氣綜合征與年齡分別對睡眠結(jié)構(gòu)的影響,并探討阻塞性睡眠呼吸暫停低通氣綜合征患者經(jīng)鼻持續(xù)氣道正壓通氣(CPAP)治療1月后睡眠結(jié)構(gòu)及治療壓力的變化。方法：根據(jù)標(biāo)準(zhǔn),從因睡眠打鼾就診并行多導(dǎo)睡眠呼吸監(jiān)測(PSG)的成年患者中篩選出222例患者,分析睡眠結(jié)構(gòu),再分別控制呼吸暫停低通氣指數(shù)(AHI)及年齡后,比較各年齡組以及不同嚴(yán)重程度OSAHS患者的睡眠結(jié)構(gòu)。再從中篩選出149例經(jīng)多導(dǎo)睡眠呼吸監(jiān)測初診為OSAHS的患者,并已接受Auto-CPAP治療1月及其前后共2次人工氣道壓力滴定試驗(yàn),比較Auto-CPAP治療前后睡眠結(jié)構(gòu)、通氣功能、治療壓力的變化。結(jié)果：1.N3睡眠與AHI的相關(guān)性最大(r=-0.361,P0.001),REM睡眠及睡眠覺醒與年齡的相關(guān)性最大(REM睡眠：r=-0.211,P=0.002;睡眠覺醒r=0.216.P=0.001)。2.四年齡組的AHI無顯著差異下,睡眠效率、N1、N2及REM睡眠、睡眠覺醒均存在顯著差異(F=7.558,3.565,3.669,3.050,5.456；P0.001,P=0.015,0.013,0.030,0.001),N3睡眠無顯著差異(F=1.518；P=0.211)。隨年齡增加,REM睡眠減少,睡眠覺醒增加。3.四組不同嚴(yán)重程度OSAHS患者中,控制年齡后,患者的N1、N2及N3睡眠存在顯著差異(F= 3.389,3.490,5.800; P= 0.011,0.017,0.001), REM睡眠無顯著差異(F=0.232,P=0.874)。中重度OSAHS患者N3睡眠隨AHI增加而減少。4. OSAHS患者中,第1天及Auto-CPAP治療1月后人工氣道壓力滴定的淺睡眠(N1、N2)比治療前顯著減少,慢波睡眠(N3)及REM睡眠顯著增加,P值均0.001。第1天人工滴定的覺醒次數(shù)較治療前顯著減少(P=0.012)。Auto-CPAP 1月后睡眠效率較治療前顯著升高(P=0.018),覺醒時(shí)間顯著減少(P= 0.035)。Auto-CPAP 1月后N2睡眠較第一次人工滴定增加(P=0.010),睡眠潛伏期縮短(P=0.022)。5. Auto-CPAP治療的最佳治療壓力隨OSAHS的嚴(yán)重程度增加而增加(CPAP-1d:F= 28.812, P 0.001; CPAP-1m:F= 19.366, P 0.001)重度OSAHS患者Auto-CPAP治療1月后最佳治療壓力下降(CPAP-1d:CPAP-1m= (9.73 ±2.6) cmH20:(9.10±2.5) cmH20, P=0.001),結(jié)論：OSAHS與年齡均與睡眠結(jié)構(gòu)相關(guān),REM睡眠及睡眠覺醒受年齡影響較大,N3睡眠受OSAHS影響較大。初始及CPAP治療1月均可改善OSAHS患者的睡眠,重度OSAHS患者CPAP治療1月后所需的治療壓力下降。第二章阻塞性睡眠呼吸暫停低通氣綜合征患者CPAP治療1月前后血糖的變化第一節(jié)CPAP 治療前 OSAHS與血糖代謝的關(guān)系目的：探討阻塞性睡眠呼吸暫停低通氣綜合征與血糖代謝的關(guān)系,并全面分析其影響因素。方法：回顧性分析180例打鼾患者,已接受多導(dǎo)睡眠呼吸監(jiān)測(PSG)、空腹血糖測量及葡萄糖耐量試驗(yàn)(oral glucose tolerance test,OGTT),分析呼吸暫停低通氣指數(shù)(AHI)、血氧飽和度、睡眠結(jié)構(gòu)及肥胖指標(biāo)與空腹血糖、OGTT-1h及OGTT-2h血糖的相關(guān)性,并比較不同嚴(yán)重程度OSAHS患者及不同程度低氧血癥患者的空腹血糖、OGTT-1h及OGTT-2h血糖的差異。結(jié)果：OSAHS患者中糖代謝紊亂的患病率高于非OSAHS患者(糖尿�。�21.4%vs.5%;糖尿病前期：34.3% vs.25%)。血糖與AHI、血氧飽和度、肥胖指標(biāo)顯著相關(guān),但與各期睡眠比例及睡眠效率無顯著相關(guān)。不同程度OSAHS患者中,空腹血糖、OGTT-1h血糖、OGTT-2h血糖都存在顯著差異(F=77.728,P0.001:P=9.003,P0.001；P=5.078,p=0.002),控制頸圍后,餐后血糖仍存在顯著差異(OGTT-1h:F= 4.679,P=0.004:OGTT-2h:F=2.683,P=0.048)。不同程度睡眠低氧血癥患者中,空腹、OGTT-1h和OGTT-2h血糖都存在顯著差異(F-75.655,P=0.004;F=5.517,P=0.001;F=76.346,P= 0.014).結(jié)論：糖代謝紊亂的風(fēng)險(xiǎn)隨OSAHS的嚴(yán)重程度增加而增加。與空腹血糖相比,餐后血糖受OSAHS的影響更大,且獨(dú)立于肥胖。相比于睡眠結(jié)構(gòu)和睡眠效率,睡眠低氧血癥與血糖代謝的相關(guān)性可能更大。第二節(jié)OSAHS患者Auto-CPAP治療1月后血糖的變化目的：探討Auto-CPAP治療1月是否改善OSAHS患者的血糖代謝。方法：根據(jù)標(biāo)準(zhǔn)從2013年1月1日-2014年5月30日因打鼾就診于睡眠醫(yī)學(xué)中心的患者中篩選出共53例男性患者,接受多導(dǎo)睡眠監(jiān)測、人工氣道壓力滴定試驗(yàn)、在家Auto-CPAP治療1月。分正常血糖、糖尿病前期(pre-DM)、糖尿病3組,比較OSAHS患者Auto-CPAP治療1月前后空腹血糖、OGTT-1h、 OGTT-2h的差異。結(jié)果：1. OSAHS患者Auto-CPAP治療1月后,pre-DM組中,空腹血糖及OGTT-lh血糖顯著下降(FPG:t= 4.160, P 0.001; OGTT-lh血糖：t=2.306,P=-0.031)；糖尿病組中,OGTT-lh及OGTT-2h血糖均顯著下降(OGTT-lh血糖：t= 2.731, P= 0.039; OGTT-2h血糖：t=2.766,P=0.025);正�；A(chǔ)血糖組中空腹血糖、OGTT-lh及OGTT-2h血糖均無顯著改變。2. OSAHS患者Auto-CPAP治療1月后,重度OSAHS組中,OGTT-1h及OGTT-2h血糖均顯著下降(OGTT-lh血糖：t= 3.367, P= 0.002; OGTT-2h血糖：t=2.664,P=0.011)；輕中度OSAHS組中,空腹血糖、OGTT-1h及OGTT-2h血糖均無顯著改變。3. OSAHS患者Auto-CPAP治療1月后,肥胖組中,OGTT-1h血糖顯著下降(t=3.195,P=0.003),而OGTT-2h血糖的改變無統(tǒng)計(jì)學(xué)意義(t=1.919,P=0.064)；非肥胖組中,空腹血糖、OGTT-1h及OGTT-2h血糖均無顯著改變。結(jié)論：Auto-CPAP治療1月可改善合并血糖代謝障礙的OSAHS患者的血糖代謝,尤其是重度、肥胖OSAHS患者。
[Abstract]:Background obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea hypopnea syndrome, OSAHS) is one of the internationally recognized major public health problems. It is a kind of sleep from the collapse of the mouth pharynx, the stenosis of the pharynx and so on, which leads to the repeated obstruction of the upper airway and reproduces the intermittent breathing and / or hypoventilation, causing intermittent hypoxia, Sleep fragmentation, hypercapnia, and so on, so as to make a series of clinical syndromes of pathophysiological changes. The main manifestations are sleep snoring, apnea, morning dryness, no lack of sleep, daylight sleepiness, and nocturia, which can cause autonomic and internal secretion disorders, produce inflammatory reactions, damaged tissues, multiple organs, and multilineage. Related diseases, such as hypertension, stroke, arrhythmia, angina and so on, seriously affect people's physical and mental health. If the treatment is not timely, the life of.OSAHS patients can be endanger, the prevalence rate of adult OSAHS is 4%, the female is as high as 2%., and the average annual medical cost of OSAHS patients is significantly higher than that of the healthy control group, and OSAHS In addition to medical costs, the economic losses caused by OSAHS, including industrial injuries, motor vehicle accidents, and the decrease of production, were 2.2 times as high as the control group, and the risk of vehicle traffic accidents was 3-7 times as much as the control group. The risk of vehicle traffic accidents was 3-7 times as much as the control group. There were 1/3 people. Time in sleep, people's growth, physical recovery and so on are done in sleep. Long term low quality sleep will make people lose attention, temper irritable, aggressive, mental fatigue, memory impairment, decline of resistance, endocrine disorder, and can also induce diseases such as coronary heart disease, hypertension, stroke, menstruation and so on. It is closely related to people's health and quality of life. And OSAHS is one of the diseases of sleep disorders. OSAHS patients can appear to increase in micro awakening, sleep fragmentation, and lead to daytime sleepiness. And age is one of the factors that affect sleep. The study found that sleep quality in different ages is different, and the elderly are more prone to sleep difficulties and sleep. Time is shorter, easy to wake up and wake up. And age is related to the development of OSAHS. However, there is a lack of study on the effects of OSAHS and age on the sleep structure of patients. Most of the sleep structures in OSAHS patients neglect the effect of age on sleep structure, and the sleep structure of OSAHS patients in each age group is not excluded from OSAHS to sleep. The effect of sleep structure on the diagnosis and treatment of.OSAHS patients can not only prevent or control the occurrence and development of diseases such as cardiovascular and cerebrovascular diseases, metabolic diseases and other diseases, but also reduce the consumption of health resources, improve the quality of life of OSAHS patients, and improve the gold standard of.OSAHS diagnosis of happiness refers to polysomnography (polyso Mnography, PSG), the preferred treatment is continuous positive airway pressure (CPAP). One of the key factors for the success of CPAP treatment is the setting of appropriate treatment pressure. The standard method for determining the best treatment pressure is artificial airway pressure titration test. The setting of appropriate CPAP treatment pressure can improve the treatment. The changes in stress and sleep structure after long-term CPAP treatment in OSAHS patients are not clear, and the related research is still lacking, especially after the release of the new AASM Reading manual of the 2007 edition. Most of the existing literature only studied the sleep structure and hypoxia after the initial CPAP treatment of OSAHS patients. Diabetes is also one of the major public health problems. Diabetes is also one of the major public health problems. In China, the prevalence of diabetes is 9.7%, the pre diabetes is 15.5%., the direct and indirect medical costs of diabetes are up to $174 billion per year, and nearly 250 thousand people die each year. But only 23.66% of the patients are aware of their own diabetes. Cardiovascular disease is the major cause of death in type 2 diabetes. In addition, diabetes can also damage the eyes, kidney and nervous system, such as.OSAHS and diabetes, the relationship between diabetes has become a research hotspot. In the study of OSAHS patients, the prevalence rate of type 2 diabetes is between 15%-30%, diabetes Early in 20%-67%. However, some of the studies have not found that the two major features of OSAHS independent of glucose metabolism disorder.OSAHS are chronic intermittent hypoxemia and sleep fragmentation, and the relationship between the two and blood glucose metabolism is still lacking a comprehensive study. Transnasal continuous positive airway pressure (continuous positive airway pressure, CPAP) Effectively reducing the apnea hypopnea index, improving hypoxemia, improving the quality of sleep, improving the patient's lethargy, cognitive dysfunction, and improving the quality of life. According to the study of CPAP treatment, the blood pressure of OSAHS patients with hypertension can be reduced, the occurrence of cardio cerebrovascular disease, arrhythmia, and cardiac function are improved; but OS There is still controversy about the improvement of blood glucose metabolism in patients with AHS after CPAP treatment, and there is still a lack of study on how the blood glucose changes after the January CPAP treatment in OSAHS patients. We will study the characteristics of OSAHS patients' sleep structure, treatment stress, and blood glucose metabolism before and after January. The first chapter of obstructive sleep apnea hypopnea syndrome The change of sleep structure and treatment pressure in patients with CPAP before and after January: a comprehensive analysis of the effects of obstructive sleep apnea hypopnea syndrome and age on sleep structure, and the treatment of sleep structure and treatment after January by nasal continuous positive airway pressure ventilation (CPAP) in patients with obstructive sleep apnea hypopnea syndrome. Methods: according to the standard, 222 patients were selected from the adult patients with sleep snoring and PSG. The sleep structure was analyzed, and the apnea hypopnea index (AHI) and age were controlled respectively. The sleep structure of all age groups and OSAHS patients with different severity was compared. 149 patients who were first diagnosed as OSAHS by polymorphic breathing were selected, and 2 artificial airway pressure titration tests were accepted in January and before and after Auto-CPAP treatment. The changes of sleep structure, ventilation function, and treatment pressure were compared before and after Auto-CPAP treatment. Results: the correlation between 1.N3 sleep and AHI was the greatest (r=-0.361, P0.001), REM sleep and sleep. The relationship between awakening and age was the greatest (REM sleep: r=-0.211, P=0.002, sleep awakening r=0.216.P=0.001).2. four age group AHI no significant difference, sleep efficiency, N1, N2 and REM sleep, sleep awakening had significant differences (F=7.558,3.565,3.669,3.050,5.456; P0.001, P=0.015,0.013,0.030,0.001), there was no significant difference in sleep. =0.211). As the age increased, REM sleep decreased and the sleep awakening increased.3. four with different severity OSAHS. After controlling the age, there were significant differences in N1, N2 and N3 sleep (F= 3.389,3.490,5.800; P= 0.011,0.017,0.001), and no significant difference in REM sleep (0.232). In the patients with OSAHS, first days and Auto-CPAP treatment after January, the superficial sleep (N1, N2) of artificial airway pressure titration was significantly lower than that before treatment, slow wave sleep (N3) and REM sleep were significantly increased, P values were significantly reduced (P=0.012) in 0.001. first days compared with before treatment (P=0.012), and the sleep efficiency was significantly higher than before the treatment (P=0.018) (P=0.018). ), the awakening time decreased significantly (P= 0.035).Auto-CPAP after January, N2 sleep was increased compared with the first artificial titration (P=0.010), and the optimal treatment pressure of.5. Auto-CPAP treatment was increased with the increase of OSAHS's severity (CPAP-1d:F= 28.812, P 0.001; CPAP-1m:F= 19.366, P 0.001) 1 severe patients. The best treatment pressure dropped after the month (CPAP-1d:CPAP-1m= (9.73 + 2.6) cmH20: (9.10 + 2.5) cmH20, P=0.001). Conclusion: OSAHS and age are related to sleep structure, REM sleep and sleep awakening are greatly influenced by age, N3 sleep is greatly influenced by OSAHS. Initial and CPAP treatment can improve the sleep of OSAHS patients in January, CPAP treatment in severe OSAHS patients. The decrease of treatment pressure required after January. The change of blood sugar in the second chapter of the patients with obstructive sleep apnea hypopnea syndrome (CPAP) before and after January, the relationship between OSAHS and blood glucose metabolism before CPAP treatment: the relationship between obstructive sleep apnea hypopnea syndrome and blood glucose metabolism, and the comprehensive analysis of the influence causes Methods: a retrospective analysis of 180 snoring patients who had received polymorphic sleep monitoring (PSG), fasting blood glucose measurement and glucose tolerance test (oral glucose tolerance test, OGTT), analyzed the apnea hypopnea index (AHI), oxygen saturation, sleep structure, and obesity index with fasting blood glucose, OGTT-1h, and OGTT-2h blood sugar. The differences in fasting blood glucose, OGTT-1h and OGTT-2h blood glucose in different severity OSAHS patients and patients with different degrees of hypoxemia were compared. Results: the prevalence of glucose metabolism disorder in OSAHS patients was higher than that of non OSAHS patients (diabetes: 21.4%vs.5%; prediabetes: 34.3% vs.25%). Blood glucose was significantly associated with AHI, blood oxygen saturation, and obesity index. There was no significant correlation between the proportion of sleep and sleep efficiency at all stages. There were significant differences in fasting blood glucose, OGTT-1h blood glucose and OGTT-2h blood glucose in different levels of OSAHS (F=77.728, P0.001:P=9.003, P0.001; P=5.078, p=0.002). After controlling the neck circumference, there were significant differences in postprandial blood glucose (OGTT-1h:F= 4.679, P=0.004:OGTT-2h:F=2.683, P=0.048). In patients with the same degree of sleep hypoxemia, there were significant differences in fasting, OGTT-1h and OGTT-2h blood sugar (F-75.655, P=0.004; F=5.517, P=0.001; F=76.346, P= 0.014). Conclusion: the risk of glucose metabolism disorder increases with the increase of the severity of OSAHS. Compared with fasting blood glucose, postprandial blood glucose is more influenced by OSAHS, and is independent of obesity. Sleep structure and sleep efficiency, sleep hypoxemia and blood glucose metabolism may be more related. Second OSAHS patients Auto-CPAP treatment after January blood glucose changes aim: To explore whether Auto-CPAP treatment in January to improve the blood glucose metabolism of OSAHS patients. Methods: according to the standard from May 30th January 1, 2013, snoring in sleep medicine A total of 53 male patients were selected from the study center, receiving polysomnography monitoring, artificial airway pressure titration test, and in the family Auto-CPAP treatment in January. Divided normal blood sugar, prediabetes (pre-DM), diabetes 3 groups, compared OSAHS patients with Auto-CPAP for the difference in fasting blood sugar, OGTT-1h, OGTT-2h before and after January. Results: Auto-CPA of 1. OSAHS patients. After P treatment in January, the fasting blood glucose and OGTT-lh blood glucose decreased significantly in the pre-DM group (FPG:t= 4.160, P 0.001; OGTT-lh blood glucose: t=2.306, P=-0.031). In the diabetic group, OGTT-lh and OGTT-2h blood glucose decreased significantly (OGTT-lh glucose: t= 2.731, 0.039; blood glucose); and the fasting blood glucose in the normal basic blood glucose group There was no significant change in OGTT-2h blood sugar in the patients with.2. OSAHS after January. In the severe OSAHS group, the blood sugar of OGTT-1h and OGTT-2h decreased significantly (t= 3.367, P= 0.002, OGTT-2h glucose, t=2.664,). After January, the blood glucose of OGTT-1h decreased significantly (t=3.195, P=0.003) in the obese group, but there was no significant change in OGTT-2h blood glucose (t=1.919, P=0.064). There was no significant change in fasting blood glucose, OGTT-1h and OGTT-2h in non obese group. Conclusion: Auto-CPAP treatment can improve the blood glucose metabolism in OSAHS patients with blood glucose metabolism disorder in January. It is a severe, obese OSAHS patient.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R766

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