OSAHS患者甲状腺激素水平对临床症状及代谢影响.docVIP

OSAHS患者甲状腺激素水平对临床症状及代谢影响 　　【摘要】 目的：探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）甲状腺激素水平在患者临床症状发生?l展及血脂血糖代谢中的意义，进一步探索改善OSAHS患者临床症状及代谢紊乱的方法。方法：选取2011年7月-2016年8月在本院经多导睡眠监测（PSG）确诊的OSAHS患者300例，依据Epworth嗜睡评分量表分为轻、中、重度嗜睡组即A、B、C组，患者分别为132、95、73例；依据血脂、血糖水平分为高血脂组106例与血脂正常组194例，血糖升高组72例与血糖正常组228例。测定并比较各组间甲状腺激素水平（FT3、FT4、TSH），依据检验结果进一步对甲状腺激素水平与嗜睡评分、血脂（TC、TG、LDL-C）进行相关性分析。临床干预阶段，选取重度OSAHS伴重度缺氧患者50例进行持续经鼻持续正压通气（n-CPAP）治疗，比较治疗前后主要睡眠参数、嗜睡评分及甲状腺激素水平变化。结果：A、B、C组各组间FT4浓度比较，差异均有统计学意义（P0.05）；进一步相关性分析结果显示，FT4与嗜睡评分呈显著负相关（r=-0.67，P0.05）；TSH和血脂水平（TC、TG、LDL）均呈不同程度负相关（r=-0.51、-0.47、-0.63，P0.05）；FT4和血脂水平（TC、TG、LDL）均呈不同程度负相关（r=-0.45、-0.39、-0.59，P0.05）。50例重度OSAHS伴重度缺氧患者经n-CPAP治疗3个月后，各项主要睡眠参数及嗜睡评分较治疗前均有明显改善（P0.05），患者TSH及FT4水平显著提高（P0.05）。结论：甲状腺功能减退对于OSAHS患者嗜睡的程度及血脂代谢具有重要影响，经n-CPAP治疗可提高甲状腺激素水平，改善患者的临床症状及血脂、血糖代谢。 　　【关键词】 OSA； 阻塞性睡眠呼吸暂停低通气综合征； 代谢综合征； 甲状腺激素水平； 血脂 　　【Abstract】 Objective：To investigate the significance of thyroid hormone levels in the blood glucose blood lipid metabolism and clinical symptoms development of the patients with OSAHS，and to further explored the methods to improve the clinical symptoms and metabolic disorders of patients with OSAHS.Method：300 cases of OSAHS diagnosed with polysomnography from July 2011 to August 2016 were selected，according to Epworth sleepiness scale（ESS），they were divided into three groups：mild sleepiness group of 132 cases（A group），moderate sleepiness group of 95 cases （B group）and severe sleepiness group of 73 cases（C group）.According to blood lipid levels，they were divided into two groups：normal blood lipid group of 194 cases and hyperlipidemia group of 106 cases.According to the levels of blood glucose，they were divided into two groups：normal glucose group of 228 cases and hyperglycemia group of 72 cases.The thyroid hormone levels in each group were measured and compared.The correlations among thyroid hormone levels，epworth sleepiness scale and blood lipid levels were further analysised.50 cases of severe OSAHS with severe hypoxia were treated with with n-CPAP in the