【摘要】 目的:观察OSA患者在CPAP治疗前后血清瘦素和胃饥饿素的变化,评价CPAP对OSA患者瘦素及胃饥饿素的影响。方法:40例OSA患者均接受CPAP治疗。分别在治疗后1周、6个月来院测定PSG。坚持治疗者,6次/周,每晚治疗时间不少于5h为入选。观察期间BMI变化≤1.5kg/m2,符合要求者18例;未符合要求者22例。设为对照组。两组分别于CPAP治疗前及后1周、6个月抽取空腹静脉血,测定瘦素、胃饥饿素、空腹血糖(FBG)、真胰岛素(TI)。瘦素和胃饥饿素的测定采用放射免疫法。结果:CPAP治疗一周结果:18例OSAS患者应用CPAP平均压力为(10.8±2.6)cmH2O,90%可信限压力为(12.59±1.3)cmH2O。AHI从(59.82±7.87)次/h降至(6.58±0.83)次/h。最低SaO2%从60.8±3.9提高到94.86±0.663。血浆胃饥饿素、瘦素有所下降,但FBG和TI无明显变化。CPAP治疗6个月结果:18例OSAS患者其CPAP平均治疗压力为(9.89±1.86)cmH2O,平均每天治疗的时间为(6.71±0.5)h,选用90%可信限压力值。患者体重BMI、NC、WHR治疗前后无明显变化。但经CPAP治疗有效地改善睡眠呼吸紊乱及低氧状态,生活质量明显提高。胃饥饿素及瘦素水平在长期的治疗后明显下降。FBG和TI也在治疗后下降。22例对照组上述各项检查无变化。结论:OSA患者血清瘦素变化是由CPAP治疗而影响并独立于BMI。CPAP长期治疗可以改善OSA的糖代谢和胰岛素抵抗。OSA是导致胃饥饿素和瘦素代谢紊乱引起体重增加,导致肥胖原因之一。更多还原

【Abstract】 Objective:To evaluate the change of ghrelin and leptin levels in patients with obstructive sleep apnea(OSA) before and after continuous positive airways pressure(CPAP).Methods:Male patients(n=26) and female patients(n=14) with OSA(index=AHI>30,BMI≥25kg/m2)who were underwent CPAP.The PSG and leptin,ghrelin,true insulin,fasting blood glucose are measured before and after the treatment one week,six months.Eighteen cases were selected who could be treated 6 times once week and 5 hours per night.Twenty-two cases are selected as control group.Results:The CPAP treatment after one week,18 patients were treated with average pressure(10.8±2.6)cmH2O,AHI from(59.82±7.87)time/h decreased to(6.58±0.83)time/h,SaO2% from (60.8±3.9) increased to(94.86±0.663),a little change of leptin and ghrelin,and no change of true insulin,fasting blood glucose were found.After six months,only 18 patients were treated by the CPAP with average pressure(9.89±1.86)cmH2O,The mean treatment time was(6.71±0.5)h/d.There was no change of body weight(BMI change <1.5kg/m2),NC、WH after treatment in those patient.There is no any change of 22 cases.Conclusions:These data indicate that the elevated leptin and ghrelin levels are not determined by obesity alone,since they decreased during CPAP therapy.The glucose metabolic disturbance and insulin resistance in OSA were improved after 6 months of CPAP therapy.OSA patients have metabolic disturbance of leptin and ghrelin,which is one of factors of obesity in OSA.更多还原