nCPAP对OSAHS患者血清脂联素水平和胰岛素抵抗的影响

摘要

[Objective]To explore the effect of nasal continual positive airway pressure(nCPAP) on serum adiponectin and insulin resistance in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).[Methods]Totally 80 adult habitual snorers were enrolled in the study and divided into mild, moderate, severe OSAHS groups and control group based on their apnea hypopnea index(AHI). Correlative clinical materials were collected and analyzed. The changes of serum adiponectin and insulin resistance in 30 severe OSAHS patients were observed before, 2 days and 3 months after nCPAP treatment. [Results]Serum adiponectin level was lower and insulin resistance was higher in severe OSAHS group than those in other groups. Insulin sensitivity increased significantly 3 months after nCPAP treatment, whereas the changes of adiponectin level before and 3 months after nCPAP treatment were not significant. [Conclusion]Both hypoadiponectinemia and insulin resistance happen in severe OSAHS patients. The nCPAP therapy for 3 months can improve insulin resistance but has no obvious effect on serum adiponectin level in OSAHS patients.%[目的]探讨经鼻持续气道正压通气治疗(nCPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清脂联素水平和胰岛素抵抗的影响.[方法]80例习惯性打鼾的成人患者纳入研究,根据其呼吸暂停低通气指数(AHI)分为轻、中、重度OSAHS组和对照组.采集并分析相关临床资料.在30例重度OSAHS患者中,分别观察其nCPAP治疗前和治疗2 d、3个月后血清脂联素水平和胰岛素抵抗变化.[结果]重度OSAHS组血清脂联素水平低于其他组而胰岛素抵抗高于其他组.nCPAP治疗3个月后患者的胰岛素敏感性明显提高而nCPAP治疗2 d或3个月脂联素水平均无明显改变.[结论]重度OSAHS患者存在低脂联素血症和胰岛素抵抗现象,nCPAP治疗3个月可以改善胰岛素抵抗,但对血清脂联素水平无明显影响.