切换至 "中华医学电子期刊资源库"

中华老年病研究电子杂志 ›› 2022, Vol. 09 ›› Issue (03) : 33 -36. doi: 10.3877/cma.j.issn.2095-8757.2022.03.008

老年糖尿病

合并阻塞性睡眠呼吸暂停低通气综合征对老年人2型糖尿病视网膜病变的影响
杨莲1,(), 罗争2, 龚娇3   
  1. 1. 441700 湖北省襄阳市谷城县人民医院眼科
    2. 441700 湖北省襄阳市谷城县人民医院耳鼻喉科
    3. 441700 湖北省襄阳市谷城县人民医院内分泌科
  • 收稿日期:2021-11-08 出版日期:2022-08-28
  • 通信作者: 杨莲

Effect of obstructive sleep apnea hypopnea syndrome on the progression of diabetic retinopathy in elderly patients

Lian Yang1,(), Zheng Luo2, Jiao Gong3   

  1. 1. Department of Ophthalmology, Gucheng Country People's Hospital, Guchen 441700, Hubei Province, China
    2. Department of Otolaryngology, Gucheng Country People's Hospital, Guchen 441700, Hubei Province, China
    3. Department of Endocrinology, Gucheng Country People's Hospital, Guchen 441700, Hubei Province, China
  • Received:2021-11-08 Published:2022-08-28
  • Corresponding author: Lian Yang
引用本文:

杨莲, 罗争, 龚娇. 合并阻塞性睡眠呼吸暂停低通气综合征对老年人2型糖尿病视网膜病变的影响[J/OL]. 中华老年病研究电子杂志, 2022, 09(03): 33-36.

Lian Yang, Zheng Luo, Jiao Gong. Effect of obstructive sleep apnea hypopnea syndrome on the progression of diabetic retinopathy in elderly patients[J/OL]. Chinese Journal of Geriatrics Research(Electronic Edition), 2022, 09(03): 33-36.

目的

探讨合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对老年2型糖尿病视网膜病变(DR)患者的影响。

方法

选取2020年3月至2021年3月谷城县人民医院收治的86例老年DR患者,其中52例合并OSAHS(OSAHS组),34例未合并OSAHS(非OSAHS组),比较两组患者的一般生化指标、24 h尿白蛋白水平、胰岛素功能、睡眠相关指标及DR病变程度的分布情况。计量资料的组间比较采用t检验,计数资料的组间比较采用χ2检验。

结果

OSAHS组患者低密度脂蛋白、餐后2 h血糖、总胆固醇、丙氨酸转氨酶以及尿酸水平均明显高于非OSAHS组(t=2.740、2.129、2.278、2.553、2.141,P<0.05或0.01);24 h尿白蛋白、空腹胰岛素、空腹C肽水平及稳态模型胰岛素抵抗指数均明显高于非OSAHS组(t=5.698、4.594、5.268、7.846,P<0.01);呼吸暂停低通气指数、氧减指数及血氧饱和度低于90%时间占睡眠时间百分比明显高于非OSAHS组(t=22.652、9.817、25.564,P<0.01),而最低血氧饱和度、平均血氧饱和度明显低于非OSAHS组(t=2.040、2.156,P<0.05)。OSAHS组中度和重度非增生DR型的发生率明显高于非OSAHS组(χ2=4.129、4.246,P<0.05)。

结论

合并OSAHS可能会影响老年DR患者的肝肾功能和糖脂代谢,从而促进中度和重度非增生型DR的发生。

Objective

To investigate the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on the progression of type 2 diabetic retinopathy (DR) in elderly patients.

Methods

A total of 86 elderly patients with DR who were diagnosed in Gucheng People's Hospital during March 2020 and March 2021 were selected. Among them, 52 cases were with OSAHS (OSAHS group) and 34 cases were without OSAHS (non-OSAHS group). The general biochemical indexes, 24-h urinary albumin, insulin function, sleep related indexes and the progression of DR were analyzed and compared between two groups. T test was used for the comparison between measurement data, and chi-square test was used for the comparison between counting data.

Results

The results of general biochemical indicators such as low-density lipoprotein, 2-hour postprandial blood glucose, total cholesterol, alanine aminotransferase and uric acid levels in OSAHS group were significantly higher than those in non-OSAHS group (t=2.740, 2.129, 2.278, 2.553, 2.141; P < 0.05 or P < 0.01); the levels of 24-hour urinary albumin, fasting insulin, fasting C-peptide and homeostasis model insulin resistance index were significantly higher than those in the non-OSAHS group (t=5.698, 4.594, 5.268, 7.846; P < 0.01); apnea and hypopnea index, oxygen desaturation index and percentage of time with SaO2 below 90% in total sleep time were significantly higher than those in non OSAHS group (t=22.652, 9.817, 25.564; P < 0.01), while the lowest and average oxygen saturation levels were significantly lower than those in non-OSAHS group (t=2.040, 2.156; P < 0.05). Patients in OSAHS group were more likely to have moderate and severe non-proliferative DR (χ2=4.129, 4.246; P < 0.05).

Conclusion

OSAHS may affect liver and kidney function, glucose and lipid metabolism in elderly patients with type 2 diabetes, and promote the occurrence of moderate and severe non-proliferative DR.

表1 两组患者一般生化指标的比较(±s
表2 两组患者24 h尿蛋白定量及胰岛素功能的比较(±s
表3 两组患者睡眠监测指标的比较(±s
[1]
Yuan F, Zhang S, Liu X, et al. Correlation between obstructive sleep apnea hypopnea syndrome and hypertension: A systematic review and meta-analysis[J]. Ann Palliat Med, 2021, 10(12):12251-12261.
[2]
李洪梅,韩旸,王凯亮. 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[J].武警医学201930(10)849-852.
[3]
魏嘉洁,矫杰,周迎生. 2型糖尿病合并阻塞性睡眠呼吸暂停综合征的临床特征及其危险因素[J]. 首都医科大学学报202041(1):35-39.
[4]
李璐希,张鹏,王延辉,等.阻塞性睡眠呼吸暂停综合征与中心性浆液性脉络膜视网膜病变的相关性研究[J].中华眼底病杂志202036(9):714-717.
[5]
闫莉,刘艳,周华,等.糖尿病视网膜病变的诊治进展[J].内科理论与实践201914(3):149-153.
[6]
中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志202113(4):315-409.
[7]
Mohammadi M, Raiegani AAV, Jalali R, et al. The prevalence of retinopathy among type 2 diabetic patients in Iran: A systematic review and meta-analysis[J]. Rev Endocr Metab Disord, 2019, 20(1):79-88.
[8]
白冰,赵文飞,吴毓敏.阻塞性睡眠呼吸暂停低通气综合征对2型糖尿病患者动态血糖及肾功能的影响[J].重庆医学201948(11):1897-1901.
[9]
Lin KY, Hsih WH, Lin YB, et al. Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy[J]. J Diabetes Investig, 2021, 12(8):1322-1325.
[10]
俞冰鸿,杨菊红,单春艳.阻塞性睡眠呼吸暂停低通气综合征与糖尿病视网膜病变的关系[J].国际内分泌代谢杂志201939(4):269-271.
[11]
姜菲,刘岩,任丽珏,等.阻塞性睡眠呼吸暂停综合征与2型糖尿病慢性并发症的相关性研究[J].中国实用内科杂志201939(11):57-60.
[12]
孙力,路荣建,葛成,等.老年人阻塞性睡眠呼吸暂停低通气综合征诊治研究进展[J].人民军医202063(2):101-103.
[13]
卢亚男,孙志新,刘丽俊,等. 2型糖尿病视网膜病变患者糖化白蛋白和糖化白蛋白/糖化血红蛋白水平的改变及其临床意义研究[J].中国糖尿病杂志201927(4):268-272.
[14]
谢香荣,李会琳,王青,等.阻塞性睡眠呼吸暂停低通气综合征对老年人2型糖尿病视网膜病变进程的影响[J].中华老年医学杂志201938(10):1126-1130.
[15]
Voigt M, Schmidt S, Lehmann T, et al. Prevalence and progression rate of diabetic retinopathy in type 2 diabetes patients in correlation with the duration of diabetes[J]. Exp Clin Endocrinol Diabetes, 2018, 126(9):570-576.
[1] 曹雯佳, 刘学兵, 罗安果, 钟释敏, 邓岚, 王玉琳, 李赵欢. 超声矢量血流成像对2型糖尿病患者颈动脉壁剪切应力的研究[J/OL]. 中华医学超声杂志(电子版), 2024, 21(07): 709-717.
[2] 陈晓玲, 钟永洌, 刘巧梨, 李娜, 张志奇, 廖威明, 黄桂武. 超高龄髋膝关节术后谵妄及心血管并发症风险预测[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 575-584.
[3] 陈翠萍, 李佩君, 杜景榕, 谢青梅, 许一宁, 卓姝妤, 李晓芳. 互联网联合上门护理在老年全髋关节置换术后的应用效果[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 676-681.
[4] 孟令凯, 李大勇, 王宁, 王桂明, 张炳南, 李若彤, 潘立峰. 袖状胃切除术对肥胖伴2型糖尿病大鼠的作用及机制研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 638-642.
[5] 李猛, 姜腊, 董磊, 吴情, 贾犇黎. 腹腔镜胃袖状切除术治疗肥胖合并2型糖尿病及脂肪胰的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 554-557.
[6] 宋俊锋, 张珍珍. 单侧初发性腹股沟斜疝老年患者经腹腹膜前疝修补术中残余疝囊腹直肌下缘固定效果评估[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 670-674.
[7] 张晋伟, 董永红, 王家璇. 基于GBD2021 数据库对中国与全球老年人疝疾病负担和健康不平等的分析比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 708-716.
[8] 袁志静, 黄杰, 何国安, 方辉强. 罗哌卡因联合右美托咪定局部阻滞麻醉在老年腹腔镜下无张力疝修补术中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 557-561.
[9] 邵世锋, 肖钦, 沈方龙, 张迅, 郝志鹏, 伍正彬, 谢晓娟, 王耀丽. 老年胸主动脉钝性伤的重症救治分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 762-767.
[10] 王贝贝, 崔振义, 王静, 王晗妍, 吕红芝, 李秀婷. 老年股骨粗隆间骨折患者术后贫血预测模型的构建与验证[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 355-362.
[11] 张骞, 唐伟, 刘丽丽. 右美托咪定复合羟考酮对老年经皮椎间孔镜腰椎间盘切除术患者术后认知功能、镇痛效果的影响[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(04): 209-214.
[12] 崔健, 夏青, 林云, 李光玲, 李心娜, 王位. 血小板与淋巴细胞比值、免疫球蛋白、心肌酶谱及心电图对中老年肝硬化患者病情及预后的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 400-406.
[13] 王璇, 娜扎开提·尼加提, 雒洋洋, 蒋升. 皮肤晚期糖基化终末产物浓度与2型糖尿病微血管并发症的相关性[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 447-454.
[14] 王星, 陈园, 热孜万古丽·乌斯曼, 郭艳英. T2DM、Obesity、NASH、PCOS共同致病因素相关的分子机制[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 481-490.
[15] 吴晓明, 翟仰魁, 王娟, 张硕, 许杰, 潘从清. 男性2 型糖尿病患者空腹C 肽和定量胰岛素敏感性检测指数与血浆致动脉粥样硬化指数的相关性[J/OL]. 中华肥胖与代谢病电子杂志, 2024, 10(04): 288-294.
阅读次数
全文


摘要