2型糖尿病合并阻塞性睡眠呼吸暂停低通气综合征持续气道正压通气疗效

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Abstract Objective To observe and evaluate the clinical efficacy of sixteen-weeks of continuous positive airway pressure (CPAP) in patients with type 2 diabetes complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Sixty patients with type 2 diabetes and OSAHS who had been diagnosed in the Department of Endocrinology in China Meitan General Hospital between January 2012 and June 2017 were randomly selected and assigned to the experimental group A (hypoglycemic drugs combined with the non-invasive ventilator) and control group B (hypoglycemic drugs), with 30 cases in each. Ways hyperglycemia was treated depended on the blood sugar value until blood sugar became normal. Patients on ventilation used the ventilator for a minimum of 6 hours a day for 16 weeks. The fasting blood glucose (FPG), postprandial blood glucose (2-hour PPG), insulin resistance index (HOMA-IR), islet β-cell function (HOME-β), glycated hemoglobin (Hb₁Ac), four items of blood lipids, apnea-hypopnea index (AHI), minimum pulse volume oxygen saturation (LSp O₂%), quality of life, and levels of satisfaction with treatment were compared between the two groups.Results The blood glucose levels of the two groups were well controlled [(FBG:Group A (6.10±0.32) mmol/L vs Group B (6.92±1.61) mmol/L;PPG: Group A (8.23±3.12) mmol/L vs Group B (8.91±2.81) mmol/L]. The difference in glycosylated hemoglobin (Hb₁Ac:6.38±0.32 vs 6.50±1.12). The four items of blood lipids [TC:(4.41±1.22) mmol/L vs (4.52±1.35) mmol/L;TG:(1.43±0.34) mmol/L vs (1.50±0.62) mmol/L;LDL-C: (2.50±0.42) mmol/L vs (2.63±0.63) mmol/L;HDL-C:(1.28±0.58) mmol/L vs (1.18±0.45 mmol/L)]was not statistically significant (P>0.05). HOMA-IR of group A was lower than that of group B (2.01±1.22 vs 3.92±1.61,P<0.001). HOMA-β(164.23±60.52 vs 104.91±52.81), AHI(4.31±1.20 vs 31.62±8.35), and LSp O₂% (95.43±3.34 vs 89.50±4.62)of group A were improved compared with group B (P<0.001). Blood glucose took less time to become normal in group than in group B(7.01±1.02 vs 10.12±1.42). The quality of life(98% vs 62%)and levels of satisfaction with treatment(100% vs 52%)(P<0.05) were higher in group A than in group B according to the survey.Conclusions The CPAP treatment of patients with type 2 diabetes complicated with OSAHS is effective, safe and feasible. It can improve insulin resistance, restore islet cell function, help blood glucose to become normal quickly, and improve the patients’ quality of life and satisfaction with treatment.

Key words： obstructive sleep apnea-hypopnea syndrome type 2 diabetes continuous positive airway pressure insulin resistance

Received: 08 January 2019

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	LI Hongmei
	HAN Yang
	and WANG Kailiang

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LI Hongmei,HAN Yang,and WANG Kailiang. Efficacy of CPAP in treating patients with type 2 diabetes and OSAHS[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(10): 849-852.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2019/V30/I10/849

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