【摘要】 目的研究合并阻塞性睡眠呼吸暂停综合征(OSAHS)的老年急性脑梗死(ACI)患者血清同型半胱氨酸(Hcy)及稳态模型胰岛素抵抗指数(HOMA-IR)水平,分析老年ACI患者OSAHS、Hcy和HOMA-IR相互关系。方法根据年龄和睡眠呼吸监测数据,将患者分为老年ACI+OSAHS组(n=21)、老年ACI组(n=30)、中年ACI+OSAHS组(n=28)和中年ACI组(n=34),检测并比较各组血清Hcy、胰岛素抵抗指数(HOMA-IR)等各指标。结果老年ACI+OSAHS组较其余3组的Hcy和HOMA-IR均升高,差异有统计学意义(P<0.05);中年ACI+OSAHS组较中年ACI组Hcy和HOMA-IR增高,差异有统计学意义(P<0.05)。Hcy与年龄、AHI、平均腰围、BMI、HOMAIR均呈正相关;多元线性回归分析显示AHI与年龄、Hcy、HOMA-IR、BMI呈正相关。结论随年龄的增加,合并OSAHS的急性脑梗死患者Hcy和HOMA-IR水平随之升高;OSAHS可能通过升高Hcy及增加胰岛素抵抗导致ACI。更多还原

【Abstract】 Objective To investigate the levels of homocysteine( Hcy) and insulin resistance in acute cerebral infarction( ACI) elderly patients with obstractive sleep apnea syndrome( OSAHS),and analysis the relationships of them.Methods The participants were divided into the elderly ACI + OSAHS group( n = 21),elderly ACI group( n = 30),middle-aged ACI + OSAHS group( n = 28) and middle-aged ACI group( n = 34) according to the age and results of polysomnography. The serum Hcy and insulin resistance( HOMA-IR) were detected,then analysis the relationship of OSAHS,Hcy and HOMA-IR. Results The Hcy and HOMA-IR levels in elderly ACI + OSAS group were higher than this in other groups( P < 0. 05); the Hcy and HOMA-IR levels in middle-aged ACI + OSAS group were higher than this in middle-aged ACI groups( P < 0. 05); the Hcy levels were positively correlated with the age,AHI,waist circumference,BMI and HOMA-IR levels; and the AHI were positively correlated with the age,Hcy,HOMA-IR levels and BMI. Conclusion The Hcy and HOMA-IR levels increased with the advancing age in ACI elderly patients with OSAHS; OSAHS may affect the Hcy and insulin resistance levels,then causes ACI.更多还原