山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (2): 48-51.doi: 10.6040/j.issn.1673-3770.0.2017.421

• ·论著· • 上一篇    下一篇

经鼻持续气道正压通气对阻塞性睡眠呼吸暂停低通气

张会芳,杨红珍   

  1. 保定市第一中心医院耳鼻咽喉科, 河北 保定 071000
  • 收稿日期:2017-10-12 出版日期:2018-03-20 发布日期:2018-03-20
  • 通讯作者: 杨红珍. E-mail:yanghongzhen2008@aliyun.com

Effects of nasal continuous positive airway pressure on glucose and lipid metabolism, hs-CRP, and

ZHANG Huifang,YANG Hongzhen   

  1. Department of Otolaryngology, Baoding First Central Hospital, Baoding 071000, Hebei, China
  • Received:2017-10-12 Online:2018-03-20 Published:2018-03-20

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摘要： 目的 探讨经鼻持续气道正压通气(NCPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者糖脂代谢和hs-CRP、S100A12水平的影响。 方法 选取40例OSAHS患者为研究对象行前瞻性研究,采用抛硬币方法将40例患者随机分为对照组和观察组,每组20例,分别予以常规保守治疗和NCPAP治疗,疗程均为3个月。治疗前后,检测各组血糖、血脂水平,hs-CRP、S100A12水平。 结果 与治疗前比较,治疗后两组患者(1) TC、TG、LDL-C水平均显著降低,而HDL-C水平显著升高,差异均有统计学意义(P<0.05)。观察组患者TC、TG、LDL-C水平明显低于对照组,而HDL-C水平明显高于对照组,差异均有统计学意义(P<0.05);(2) FBG和2 h PBG水平显著降低,差异均有统计学意义(P<0.05)。观察组患者FBG和2 h PBG水平明显低于对照组,差异均有统计学意义(P<0.05);(3) hs-CRP、S100A12水平均显著降低,差异均有统计学意义(P<0.05)。观察组患者hs-CRP、S100A12水平明显低于对照组,差异均有统计学意义(P<0.05)。 结论 经鼻持续气道正压通气能够显著调节OSAHS患者糖脂代谢,降低hs-CRP、S100A12水平,从而减少OSAHS患者心血管疾病并发症,改善预后。

关键词: 钙结合蛋白S100A12, 睡眠呼吸暂停, 阻塞性, 糖脂代谢, C-反应蛋白, 无创正压通气

Abstract: Objective To investigate the effects of nasal continuous positive airway pressure(NCPAP)on the levels of glucose and lipid metabolism, hs-CRP and S100A12 in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Forty OSAHS patients were selected for prospective study, and randomly divided into a control group(receiving routine conservative treatment)and an experimental group(receiving NCPAP treatment)by the coin-tossing method, with each group containing 20 patients. The treatment continued for 3 months. Before and after treatment, the levels of blood glucose, blood lipid, hs-CRP and S100A12 were analyzed. Results In both groups, the levels of total cholesterol(TC), triglyceride(TG)and LDL cholesterol were significantly decreased after treatment, while the levels of HDL cholesterol were significantly increased(all P<0.05). (1) The levels of TC, TG and LDL-C in the experimental group were significantly lower than those in the control group, while the levels of HDL-C in the experimental group were significantly higher than those in the control group(P<0.05). (2) Fasting blood glucose(FBG)and 2 h postprandial blood glucose(PBG)levels were significantly decreased after treatment(P<0.05). The levels of FBG and 2 h PBG were significantly lower in the observation group than in the control group(P<0.05). (3) hs-CRP and S100A12 levels were significantly decreased after treatment(P<0.05). The levels of hs-CRP and S100A12 in the experimental group were significantly lower than in the control group(P<0.05). Conclusion Nasal continuous positive airway pressure can significantly regulate blood glucose and lipid metabolism and reduce hs-CRP and S100A12 levels in patients with OSAHS, thereby reducing the cardiovascular complications of OSAHS patients and improving their prognosis.

Key words: Sleep apnea, obstructive, Non-invasive positive pressure ventilation, Glyco-lipid metabolism, C-reactive protein, Calcium binding protein S100A12

中图分类号: 

  • R766.7
[1] 王钰彧, 关建, 殷善开. 阻塞性睡眠呼吸暂停低通气综合征的筛查诊断研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 13(6):505-509. WANG Yuyu, GUANG Jian, YIN Shankai. Screening of sleep apnea syndrome-a review of current situation[J]. Clin J Otorhinolarynol Head Neck Surg, 2016, 13(6):505-509.
[2] 何权瀛, 王莞尔. 阻塞性睡眠呼吸暂停低通气综合征诊治指南(基层版)[J]. 中国呼吸与危重监护杂志, 2015, 29(4):398-405. HE Quanying, WANG Waner. Obstructive sleep apnea-hypopnea syndrome diagnosis and treatment guidelines(grassroots version)[J]. China Respiratory and Critical Care Med, 2015, 19(4):398-405.
[3] 张鹏, 欧阳松云, 孙培宗, 等. 无创正压通气对睡眠呼吸暂停综合征合并心律失常的影响[J]. 中华心血管病杂志, 2013, 41(9): 747-750. ZHANG Peng, OUYANG Yunsong, SUN Peizong, et al. Effect of noninvasive positive pressure ventilation on sleep apnea syndrome with arrhythmia[J]. Chin J of Card Dise, 2013, 41(9):747-750.
[4] 罗遐杰, 叶宏波, 卢艳萍,等. 阻塞性睡眠呼吸暂停低通气综合征并发慢性阻塞性肺疾病的相关因素分析[J]. 中华全科医学, 2016, 14(3):417-419. LUO Yajie, YE Hongbo, LU Yanping, et al. Related factors of obstructive sleep apnea hypopnea syndrome complicated with chronic obstructive pulmonary disease[J]. Chin Gen Pract, 2016, 14(3):417-419.
[5] 叶焕荣, 陈美华, 叶树培. 经鼻持续气道正压通气干预前后OSAHS患者睡眠及糖代谢水平变化的分析[J]. 国际呼吸杂志, 2017, 37(9):680-683. YE Huanrong, CHEN Meihua, YE Shupei. Changes of sleep and glucose metabolism in patients with OSAHS before and after the intervention of nasal continuous positive airway pressure[J]. Int Respir Mag, 2017, 37(9):680-683.
[6] 田昭涛, 李慧丽, 崔云亮. 无创通气联合硫酸镁对肺心病伴呼吸衰竭患者血浆hs-CRP、NT-proBNP的影响[J]. 山东医药, 2014, 54(8):45-46. TIAN Zhaotao, LI Huili, CUI Yunliang. Effect of non-invasive ventilation combined with magnesium sulfate on plasma hs-CRP and NT-proBNP in patients with pulmonary heart disease and respiratory failure[J]. Shandong Med, 2014, 54(8):45-46.
[7] 王红燕. 血清CRP、NT-proBNP与高血压合并阻塞性睡眠呼吸暂停低通气综合征患者血压变异性[J]. 临床心血管病杂志, 2016, 9(4):377-380. WANG Hongyan. Blood pressure variability in patients with obstructive sleep apnea-hypopnea syndrome associated with serum CRP, NT-proBNP and hypertension[J]. J Clin Cardiol, 2016, 9(4):377-380.
[8] 焦兴爱, 应央央, 马德东. 阻塞性睡眠呼吸暂停低通气综合征治疗的最新进展[J]. 中国实用护理杂志, 2014, 30(9):76-78. JIAO Xingai, YING Yangyang, MA Dedong. Recent progress in the treatment of obstructive sleep apnea-hypopnea syndrome[J]. Chin J Prac Nurs, 2014, 30(9):76-78.
[9] 董瑞芳, 史方堃, 杜俊凤,等. 持续气道正压通气治疗急性脑梗死合并OSAHS的效果及作用机制[J]. 山东医药, 2017, 57(5):78-80. DONG Ruifang, SHI Fangkun, DU Junfeng, et al. Continuous positive airway pressure in the treatment of acute cerebral infarction complicated with OSAHS and its mechanism of action[J]. Shandong Med, 2017, 57(5):78-80.
[10] 郭雪玲, 刘辉国. 慢性间歇低氧血管内皮功能障碍与氧化应激的关系研究进展[J]. 中华结核和呼吸杂志, 2012, 35(3):203-206. GUO Xueling, LIU Huiguo. Research progress on the relationship between chronic intermittent hypoxic vascular endothelial dysfunction and oxidative stress[J]. Chin J Tub and Respiratory Diseases, 2012, 35(3):203-206.
[11] 韩书芝, 李冲, 平芬,等. 阻塞性睡眠呼吸暂停低通气综合征患者糖、脂代谢紊乱的研究[J]. 国际呼吸杂志, 2014, 34(9):659-662. HAN Shuzhi, LI Cong, PING Fen, et al. Study on disturbance of glucose and lipid metabolism in patients with obstructive sleep apnea and hypopnea syndrome[J]. Int Respir Mag, 2014, 34(9):659-662.
[12] Lin QC, Chen LD, Yu YH, et al. Obstructive sleep apnea syndrome is associated with metabolic syndrome and inflammation[J]. Eur Arch Otorhinolaryngol, 2014, 271(4):825-831.
[13] Lin QC, Chen LD, Yu YH, et al. Association between nocturnal hypoxia and liver injury in the setting of nonalcoholic fatty liver disease[J]. Sleep Breath, 2015, 19(1):273-280.
[14] Cholidou KG, Kostakis ID, Manali ED, et al. Calprotectin a protein related to cardiovascular risk in adult patients with obstructive sleep apnea[J]. Cytokine, 2013, 61:917-923.
[15] Saito T, Hojo Y, Ogoyama Y, et al. S100A12 as a marker to predict cardiovascular events in penitents with chronic coronary artery disease[J]. Cire J, 2012, 76(11):2647-2652.
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