兰州大学机构库 >学院待认领
2型糖尿病合并OSAHS临床内分泌研究分析
Alternative TitleRegulation of thyroxine and HPA-axis and growth hormone in Type 2 diabetes with OHAHS patients
郑鹏
Thesis Advisor刘静
2014-05-23
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword糖尿病 2型 阻塞性睡眠呼吸暂停 甲状腺素 ACTH GH CORL
Abstract目的:探讨合并阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome,OSAHS )的2型糖尿病(Type 2 diabetes mellitus,T2DM ) 患者体内内分泌激素水平的变化,从而为进一步了解2型糖尿病合并OSAHS患者体内内分泌的发生机制和水平变化提供理论依据。 方法:入选标准入住我院的单纯T2DM患者,T2DM+OSAHS患者,单纯OSAHS患者和体检中心正常对照组人群。均除外不稳定临床疾病、妊娠期糖尿病或正进行肾脏替代治疗者。以空腹血糖≥7mmol/l,服用75g葡萄糖粉或者进食馒头餐后2h血糖≥11mmol/l为标准选取2型糖尿病患者100例;OSAHS患者的选取应用多导睡眠图监测来进行确证,据此建立的健康单纯OSAHS患者组100例;同时建立合并有OSAHS的T2DM患者100;最后筛查出正常人群组100例,总计4组共400例患者。测量身高、体重、腰围、臀围,并计算体重指数(BMI)、腰臀比(WHR)及脂肪百分比(%FAT)。BMI:18.5-25kg/m2作为正常线,作为界定肥胖与非肥胖组的标准。WHR以男子腰臀比值≥0.85、女子腰臀比值≥0.80为肥胖的界限;上述结果测定%FAT,男子体脂数值≥25%,女子体脂数值≥30%为肥胖。原有2型糖尿病患者均维持原治疗方案不变,在此基础上采取受试者隔夜禁食10小时,于次日清晨8A.M.取肘正中静脉血液,检测血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)、血清甲状腺素(T4)、血清三碘甲腺原氨酸(T3)、血清促甲状腺素(TSH),促肾上腺皮质激素(ACTH )、血浆皮质醇(CORL)、血清生长激素(GH ).并于同日4P.M.同样采受试者的肘正中静脉血液,二次检测血清皮质醇;记录的监测指标包括呼吸暂停低通气指数(AHI)、最低血氧饱和度(LOX)等,同时根据AHI和夜间Sa02将OSAHS患者分为轻、中、重度三组。分别比较四组之间,以及不同程度OSAHS患者之间的颈围、腰围、腰臀比、BMI,年龄以及检测FT3,FT4、T4、T3、TSH、ACTH、CORL、GH等各项指标间的差异. 结果:1.2型糖尿病合并OSAHS患者组中BMI与%FAT高于对照组,差异均临床统计意义(P<0.05)。四组之间其他指标(年龄、腰围、腰臀比)比较均无显著性临床统计意义(P>0.05)。 2.2型糖尿病合并OSAHS组FT3低于对照组,数值有统计学意义(P<0.05)。余组其他指标比较无明显统计学意义。 3 将0SAHS患者按轻中重与正常对照组比较,发现随着OSAHS病情的程度不同,FT3,T3.FT4,T4,TSH水平均发现变化,在不同组别之间的差异性比较有统计学意义(P<0.05)。 4.单纯OSAHS患者,单纯T2DM组患者,2型糖尿病合并OSAHS组患者血清ACTH血浆皮质醇水平与正常对照组均呈正相关P<0.05),有统计学意义。 5.单纯T2DM组和单纯OSAHS患者血清GH水平与正常组对比P<0.05),而T2DM合并OSAHS组与正常组比均无统计学意义上的相关性(P>0.05)。 结论: 1.OSAHS患者的BMI水平明显高于对照组,并且BMI升高的水平与OSAHS患者的病情程度指标存在相关性,提示BMI水平与OSAHS存在正相关。 2.2型糖尿病合并OSAHS患者组FT3血清浓度虽均在正常范围内,可是数值高于对照组,提示2型糖尿病合并OSAHS组患者有出现甲状腺代谢功能异常的趋势。 ...
Other AbstractObjective:To investigate patients with obstructive sleep apnea syndrome (OSAHS) of type 2 diabetes (T2DM) Patients with endocrine changes in hormone levels , which conduct research to further understand the mechanisms and changes in the body 's endocrine OSAHS patients. Methods: Inclusion criteria were 38 to 72 years of pure T2MD hospital patients , T2DM + OSA patients , pure OSA patients and normal control population . All except unstable clinical disease , gestational diabetes or undergoing renal replacement therapy. Diagnosis of diabetes with fasting blood glucose greater than 7mmol / l, taking 75g glucose powder or eating bread 2H postprandial blood glucose greater than 11mmol / l standard select diagnosed with type 2 diabetes, 100 patients ; OSAHS patients selected for polysomnographic monitoring application for confirmed , and the exclusion of 0SAHS whereby patients and 100 healthy pure OSAHS patients with established ; while building associated with OSAHS group of 100 cases of T2DM patients and normal subjects screened group 100 cases , a total of 400 cases of 4 groups patients. Measurement of height, weight , waist circumference , hip circumference, and body mass index (Body Mass Index, BMI), waist-hip ratio (waist-to-hip ratio, WHR) and fat percentage (percentage of body fat,% FAT). BMI (Body Mass Index, BMI) 18.5-25kg/m2 as the normal line, as defined in the standard of obese and non -obese group . WHR (waist-to-hip ratio, WHR) hip ratio greater than or equal to 0.85 man , woman hip ratio greater than 0.80 is equal to the limits of abdominal obesity. Fat percentage measured by skin fold thickness and bioelectrical impedance analysis (percentage of body fat,% FAT), men value greater than or equal to 25% body fat , fat woman values greater than or equal to 30 % were obese . For the original type 2 diabetes remained unchanged original treatment regimen , take subjects fasted for 10 hours overnight on this basis , the next morning 8A. M. Take cubical vein blood , serum free three triiodothyronine (FT3), serum free thyroxine (FT4), serum thyroxine (T4), serum triode thyroxin , serum thyrotrophic (TSH) , adrenocorticotropic hormone(adreno-cortico-tropic-hormone ACTH), cortical (cortical), serum GH (growth hormone GH). And adopt the same subjects at 4PM cubical vein blood on the same day , the second serum cortical (cortical); monitoring indicators recorded include apnea hypopnea index (Apnea.Hypopnea Index, AHI), lowest oxygen saturation ( lowest o...
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Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/224282
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
郑鹏. 2型糖尿病合并OSAHS临床内分泌研究分析[D]. 兰州. 兰州大学,2014.
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