【摘要】 目的:探讨悬壅垂腭咽成形+舌根射频减容(伴或不伴下鼻甲射频)+颏舌肌前移术(UPPP+RF+GA)手术方案对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者胰岛素抵抗(IR)的影响。方法:确诊42例重度OSAHS患者,对其中22例进行UPPP+RF+GA多平面综合手术治疗(治疗组);20例患者未行任何治疗(未治疗组),在术前1 d及术后6个月对两组患者进行多导睡眠监测(PSG)检查,记录呼吸暂停低通气指数(AHI)、血氧饱和度(SO2),同时测定空腹血糖(FBG)、空腹胰岛素(FINS),计算稳态模型-胰岛素抵抗指数(HOM0-IR),评估该手术治疗对重度OSAHS患者IR的影响。另选择20例健康者为对照组。结果:①治疗组与未治疗组比较,以及治疗组术前与术后比较,IR各指标(FBG、FINS、HOM0-IR)差异均有统计学意义(P<0.01或P<0.05);②重度OSAHS患者FPG、FINS和AHI呈正相关,与SO2呈负相关。结论:OSAHS与IR之间存在独立相关性,UPPP+RF+GA手术治疗能改善重度OSAHS患者的IR。更多还原

【Abstract】 Objective: To explore the effect of a comprehensive surgical approach of uvulopalatopharyngoplasty plus radio-frequency plus genioglossus advancement(UPPP+RF+GA) on insulin resistance in patients with severe obstructive sleep apnea hypopnea syndrome(OSAHS).Methods: Forty-two patients with severe OSAHS were selected as trial group.Twenty-two patients(treatment group) among them received a comprehensive surgical approach of UPPP+RF+GA,while the other twenty patients received no treatment(no treatment group).All indexes of the nocturnal polysomnography(PSG),Fast blood glucose(FBG) and fast insulin(FINS) were analysed before and after surgical treatment.The other 20 normal subjects were selected as control group.Results: ①FBG,FINS and HOM0-IR were significantly higher in treatment group than that in no treatment group(P<0.01或P<0.05).FBG,FINS and HOM0-IR were also significantly higher before operation than that after operation(P<0.01或P<0.05).②FBG and FINS were signifi-cantly positively correlated to AHI,but negatively correlated to SO2.Conclusion: OSAHS may be independently associated with insulin resistance.The surgical approach of UPPP+RF+GA may be an effective treatment to improve insulin sensitivity for patients with severe OSAHS.更多还原