【摘要】 目的 探讨T2DM合并阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者下肢血管病变（LEAD）的影响因素。方法 选取2020年9月至2021年12月于太原糖尿病专科医院内分泌科住院治疗的T2DM患者132例，按照合并OSAHS程度分为单纯T2DM组[睡眠呼吸暂停次数（AHI）<5或最低动脉血氧饱和度（LSaO₂）>90%,n=40]、OSAHS轻度组（5≤AHI≤15或85%≤LSaO₂≤90%,n=42）、OSAHS中重度组（AHI>15或LSaO₂<85%,n=50）。检测各组血清8‐异前列腺素F2α（8‐iso‐PGF2α）、氧化低密度脂蛋白（OX‐LDL）、谷胱甘肽过氧化物酶（GSH‐Px）、超氧化物歧化酶（SOD）及踝肱指数（ABI）。Pearson相关分析ABI与其他指标的相关性。Logistic回归分析LEAD的影响因素。结果 与T2DM组比较，OSAHS中重度组BMI升高（P<0.05）。OSAHS中重度组HbA₁c、AHI、8‐iso‐PGF2α、OX‐LDL、LSaO₂<85%高于T2DM、OSAHS轻度组，ABI、SOD、GSH‐Px低于T2DM、OSAHS轻度组（P<0.05）。Pearson相关分析显示，ABI与SOD、GSH‐Px呈正相关（P<0.05），与HbA₁c、8‐iso‐PGF2α、OX‐LDL、AHI呈负相关（P<0.05）。Logistic回归分析显示，HbA₁c、AHI、8‐iso‐PGF2α、OX‐LDL、SOD、GSH‐Px是LEAD的影响因素。结论 氧化应激反应加重T2DM合并OSAHS患者LEAD,T2DM合并LEAD患者应进行睡眠呼吸过筛监测。更多还原

【Abstract】 Objective To investigate the effect of oxidative stress on the severity of lower extremity vascular disease（LEAD）in patients with type 2 diabetes mellitus（T2DM）complicated with obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods A total of 132 T2DM patients hospitalized in Taiyuan Diabetes Hospital from September 2020 to December 2021 were selected and divided into the non‐OSAHS group[AHI<5 or minimum blood oxygen saturation（LSaO₂）>90%according to the degree of OSAHS.n=40],OSAHS mild group（5≤AHI≤15 or 85%≤LSaO₂≤90%,n=42）,OSAHS moderate to severe group（AHI>15 or LSaO₂<85%,n=50）.Serum levels of 8‐isoprostaglanin F2α（8‐iso‐PGF2α）,oxidized low density lipoprotein（OX‐LDL）,glutathione peroxidase（GSH‐Px）,superoxide dismutase（SOD）and ankle‐brachial index（ABI）were detected in all groups.Pearson correlation analysis was used to analyze the correlation between ABI and other indicators.The influencing factors of LEAD was analyzed by logistic regression.Results Compared with T2DM group,BMI of moderate and severe OSAHS group increased（P<0.05）.The levels of HbA₁c,AHI,8‐iso‐PGF2α,OX‐LDL and the rate of LSAO₂<85%in moderate and severe OSAHS group were higher,while ABI,SOD and GSH‐Px were lower than those in T2DM and mild OSAHS group（P<0.05）.Pearson correlation analysis showed that ABI was positively correlated with SOD and GSH‐Px（P<0.05）and negatively correlated with HbA₁c,8‐iso‐PGF2α,OX‐LDL and AHI（P<0.05）.Logistic regression analysis showed that HbA₁c,AHI,8‐iso‐PGF2α,OX‐LDL,SOD and GSH‐Px were the influencing factors of lower LEAD.Compared with T2DN group,BMI of moderate and severe OSAHS group increased（P<0.05）.The levels of HbA₁c,8‐iso‐PGF2α,OX‐LDL and the rate of LSAO₂<85%in moderate and severe OSAHS group were higher,while ABI,SOD and GSH‐Px were lower than those in T2DM and mild OSAHS group（P<0.05）.Pearson correlation analysis showed that ABI was positively correlated with SOD and GSH‐Px（P<0.05）and negatively correlated with HbA₁c,8‐iso‐PGF2α,OX‐LDL and AHI（P<0.05）.Logistic regression analysis showed that HbA₁c,AHI,8‐iso‐PGF2α,OX‐LDL,SOD and GSH‐Px were the influencing factors of LEAD.Conclusion OSAHS can enhance oxidative stress response and aggravate diabetic LEAD.T2DM patients complicated with LEAD should be monitored by sleep breathing screening.更多还原