本文選題：阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)　切入點(diǎn)：瘦素　出處：《延邊大學(xué)》2011年碩士論文

【摘要】：目的：觀察阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者采用改良式UPPP和(或)鼻內(nèi)鏡下鼻中隔成形手術(shù)治療前后瘦素、血脂的變化。用于對OSAHS的早期篩查和診斷,評價手術(shù)遠(yuǎn)期治療效果。 方法： 1、選擇OSAHS患者24例,患者年齡25-61(43.37±9.32)歲。體重指數(shù)25.91±2.73kg/M2,所有患者均有夜間睡眠中打鼾、呼吸暫停及白天嗜睡等病史,經(jīng)纖維鼻咽喉鏡檢和多導(dǎo)睡眠儀(polysomnography,PSG)監(jiān)測確診。 2、選擇OSAHS手術(shù)后(術(shù)后半年至一年)患者22例,患者年齡23--62(42.67±10.25)歲,體重指數(shù)24.68±2.52kg/M2,所有患者均經(jīng)多導(dǎo)睡眠儀(polysomnography, PSG)監(jiān)測。 3、選擇健康對照組20例,年齡21-60(42.69±9.64)歲,體重指23.78±2.66 kg/m2。所有研究對象均除外高血壓、慢性肺部病變、神經(jīng)肌肉疾病、甲狀腺疾病及其他內(nèi)分泌疾病、營養(yǎng)代謝疾病、冠心病、腦血管意外等其他全身疾病。 所有入選者在睡眠監(jiān)測結(jié)束,晨醒10分鐘內(nèi)抽取肘腹靜脈血6ml,分別應(yīng)用酶聯(lián)免疫法檢測血清瘦素(Leptin)水平及用全自動生化分析儀檢測血脂水平,包括總膽固醇(total cholestein,TC)、甘油三酯(triglyceride, TG)、低密度脂蛋白膽固醇(low-density lipoprotein cholestein, LDL-C)、高密度之蛋白膽固醇(high-density lipoprotein cholestein, HDL-C)。 所有資料均應(yīng)用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)處理,記量資料以x±S表示,多組間均數(shù)比較采用單因素方差分析,兩變量間的相關(guān)性采用直線相關(guān)分析,P0.05表示有統(tǒng)計(jì)學(xué)意義。 結(jié)果： 1、OSAHS術(shù)后組與OSAHS組患者比較Leptin降低、TC降低、TG降低、LDL-C降低、HDL-C升高。P0.01,具有統(tǒng)計(jì)學(xué)意義。 2. OSAHS術(shù)后組患者與健康對照組比較Leptin、TC、TG、LDL-C、HDL-C, p0.05,無統(tǒng)計(jì)學(xué)意義。 3、直線相關(guān)分析顯示： OSAHS組患者Leptin與AHI呈正相關(guān)(r=0.547)；與最低SaO2呈負(fù)相關(guān)(r=-0.334)；與BMI呈正相關(guān)(r=0.384)；與TC呈正相關(guān)(r=0.636),與TG呈正相關(guān)(r=0.524),與LDL-C呈正相關(guān)(r=0.671);HDL-C呈負(fù)相關(guān)(r=-0.723)；TC與AHI正相關(guān)(r=0.692),與最低SaO2呈負(fù)相關(guān)(r=-0.254)；TG與AHI呈正相關(guān)(r=0.734),與最低SaO2呈負(fù)相關(guān)(r=-0.482);LDL-C與AHI呈正相關(guān)(r=0.587),與最低SaO2負(fù)相關(guān)(r=-0.143);HDL-C與AHI呈負(fù)相關(guān)性(r=-0.625),與最低SaO2呈正相關(guān)(r=0.175)。 結(jié)論 OSAHS患者存在瘦素水平、血脂的紊亂,經(jīng)改良式UPPP和(或)鼻內(nèi)鏡下鼻中隔成形手術(shù)治療Ⅰ型和Ⅱ型OSAHS患者后可以證實(shí),缺氧得到改善,瘦素、血脂水平得到逆轉(zhuǎn)。檢測瘦素和血脂有助于OSAHS早期篩查,預(yù)防并發(fā)癥,用于OSAHS病人的流行病學(xué)調(diào)查指標(biāo)；并可用于觀察手術(shù)遠(yuǎn)期療效的測定指標(biāo)。
[Abstract]:Objective: to observe the changes of leptin and serum lipids in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after nasal septoplasty with modified UPPP and / or nasal endoscope. To evaluate the effect of long-term surgical treatment. Methods:. 1. Twenty-four patients with OSAHS were selected. The age of the patients was 25-61kg, 43.37 鹵9.32 years old. The BMI was 25.91 鹵2.73kg / m2. All the patients had a history of snoring, apnea and daytime sleepiness during night sleep, which were confirmed by fiberoptic nasolaryngoscopy and polysomnography PSG. 2Twenty two patients (half a year to one year after OSAHS) were selected. The patients were aged from 23 to 62.67 鹵10.25 years old and had a body mass index of 24.68 鹵2.52 kg / m2. All the patients were monitored by polysomnography (PSG). 3Twenty healthy control subjects, aged 21-60 years, 42.69 鹵9.64 years old, weight index 23.78 鹵2.66 kg / m2. All subjects were excluded hypertension, chronic pulmonary disease, neuromuscular disease, thyroid disease and other endocrine diseases, nutritional metabolic disease, coronary heart disease. Cerebrovascular accident and other systemic diseases. At the end of sleep monitoring, 6 ml of venous blood was drawn from the elbow ventral vein within 10 minutes of waking in the morning. The serum leptin Leptin level was detected by enzyme-linked immunosorbent assay (Elisa) and the blood lipid level was measured by automatic biochemical analyzer. These include total total cholesterol, triglyceride, triglyceride, low density lipoprotein cholesterol, low density lipoprotein cholesteatrin, high density protein cholesterol, high density lipoprotein cholesteate, and high density protein cholesterol. All the data were processed by SPSS17.0 statistical software, the recording data were expressed as x 鹵S, the mean of multiple groups was analyzed by single factor ANOVA, and the correlation between the two variables was expressed by linear correlation analysis (P0.05). Results:. 1 compared with OSAHS group, Leptin decreased TC, TG decreased, LDL-C decreased and HDL-C increased in OSAHS group compared with OSAHS group, which had statistical significance. 2. There was no significant difference in HDL-C (p0.05) between OSAHS group and healthy control group. 3. Linear correlation analysis shows that:. In OSAHS group, there was a positive correlation between Leptin and AHI, a negative correlation with minimum SaO2, a negative correlation with SaO2, a positive correlation with BMI, a positive correlation with TC, a positive correlation with TC, a positive correlation with TG, a positive correlation with TG, a negative correlation with LDL-C, a positive correlation between TC and AHI, and a negative correlation between TC and AHI. There was a positive correlation between AHI and minimum SaO2, a positive correlation between LDL-C and AHI, a negative correlation between LDL-C and AHI, a negative correlation between HDL-C and AHI, and a positive correlation between LDL-C and minimum SaO2. Conclusion. Leptin levels and dyslipidemia were found in patients with OSAHS. After modified UPPP and / or nasal endoscopic septoplasty for patients with type I and type 鈪，

本文編號：1683750