城镇男性阻塞性睡眠呼吸暂停低通气综合征患者睾酮水平的研究
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摘要
目的:研究城镇成年男性OSAHS患者的血清睾酮(T)水平及nCPAP治疗对上述患者血清睾酮水平的影响。
方法:182例入选者经PSG监测,按年龄分25-45岁、46-65岁两层,正常对照组(20例、21例)、单纯性鼾症组(14例、13例),OSAHS患者再按睡眠呼吸紊乱严重程度进行分组:轻度OSAHS组(21例、17例)、中度OSAHS组(19例、19例)、重度OSAHS组(18例、20例),在PSG监测次晨抽取外周静脉血用电化学发光法测定血清睾酮水平。对比正常对照组、单纯性鼾症组、OSAHS组间睾酮水平的差异,分析睾酮水平与AHI、BMI之间的相关性。对上述中重度OSAHS患者接受nCPAP治疗及未接受该治疗组随访3个月,复查并比较PSG及血清睾酮指标的变化。
结果:(1)正常对照组与单纯性鼾症组2组间血清睾酮差异无统计学意义(P均>0.05)。OSAHS组血清T较正常对照组及单纯性鼾症组低。(2)T与AHI、BMI、年龄均呈负相关关系(r = -0.589,P<0.01;r = -0.225, P<0.05; r = -0.454 P<0.01)T与最低SaO2值呈正相关、(r =0.459 P<0.01;)。(3)中重度OSAHS患者中,接受nCPAP治疗者随访3个月后,血清睾酮水平升高(P <0.01)。未接受nCPAP治疗者随访3个月后,血清睾酮水平无明显变化(P>0.05)。
结论:OSAHS患者血清睾酮水平低,血清睾酮水平与AHI、BMI负相关。OSAHS患者血清睾酮水平随年龄增加而降低。nCPAP治疗可改善中、重度OSAHS患者血清睾酮水平。
Objective To explore the testosterone levels in urban male patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) and effects of nasal continuous positive airway pressure(n CPAP) treatment. Method With polysomnographic monitoring , 182 OSASHS patients were assigned to 25-45 years old patients group and 46-65years old group .The two groups consist of: the simple snores patients (14,13cases ), control groups (20,21 cases ),mild OSAHS(21,17cases ), moderate OSAHS(19,19 cases ), severe OSAHS(18 ,20cases ). The serum level of testosterone (T) was measured after sleeping for 7 hours with the polysomnographic(PSG) monitoring The 76 patients with moderate to severe OSAHS according to the PSG results were divided into“nCPAP group”(n=29) who underwent nCPAP therapy and“non- nCPAP group”(n=47) who did not undergo nCPAP therapy. Ten patients were excluded from the follow-up study for private reasons . The assessment protocol was then repeated after 3 months . Results (1) There were no significant differences of the serum level of T between simple snores and control group. The serum level of T was significantly lower in OSAHS patient than in the control group . (2) the serum level of T was negatively correlated with AHI,BMI,ages (r = --0.589 p<0.01;r = --0.225 p<0.05; r = -0.454 p<0.01)with Liner regression analysis,and the T level was positively correlated with SaO2(r =0.459 p<0.01). (3) After 3 months’nCPAP therapy in OSAHS patients, the serum level of T was significantly increased( p<0.01),w hile there were no similar changes in OSAHS patients without nCPAP therapy(p>0.05). Conclusion OSAHS patients have lower level of T. The serum level of T was negatively correlated with AHI、BMI. The serum level of T may be increased by nCPAP therapy in moderate to severe OSAHS patients.
方法:182例入选者经PSG监测,按年龄分25-45岁、46-65岁两层,正常对照组(20例、21例)、单纯性鼾症组(14例、13例),OSAHS患者再按睡眠呼吸紊乱严重程度进行分组:轻度OSAHS组(21例、17例)、中度OSAHS组(19例、19例)、重度OSAHS组(18例、20例),在PSG监测次晨抽取外周静脉血用电化学发光法测定血清睾酮水平。对比正常对照组、单纯性鼾症组、OSAHS组间睾酮水平的差异,分析睾酮水平与AHI、BMI之间的相关性。对上述中重度OSAHS患者接受nCPAP治疗及未接受该治疗组随访3个月,复查并比较PSG及血清睾酮指标的变化。
结果:(1)正常对照组与单纯性鼾症组2组间血清睾酮差异无统计学意义(P均>0.05)。OSAHS组血清T较正常对照组及单纯性鼾症组低。(2)T与AHI、BMI、年龄均呈负相关关系(r = -0.589,P<0.01;r = -0.225, P<0.05; r = -0.454 P<0.01)T与最低SaO2值呈正相关、(r =0.459 P<0.01;)。(3)中重度OSAHS患者中,接受nCPAP治疗者随访3个月后,血清睾酮水平升高(P <0.01)。未接受nCPAP治疗者随访3个月后,血清睾酮水平无明显变化(P>0.05)。
结论:OSAHS患者血清睾酮水平低,血清睾酮水平与AHI、BMI负相关。OSAHS患者血清睾酮水平随年龄增加而降低。nCPAP治疗可改善中、重度OSAHS患者血清睾酮水平。
Objective To explore the testosterone levels in urban male patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) and effects of nasal continuous positive airway pressure(n CPAP) treatment. Method With polysomnographic monitoring , 182 OSASHS patients were assigned to 25-45 years old patients group and 46-65years old group .The two groups consist of: the simple snores patients (14,13cases ), control groups (20,21 cases ),mild OSAHS(21,17cases ), moderate OSAHS(19,19 cases ), severe OSAHS(18 ,20cases ). The serum level of testosterone (T) was measured after sleeping for 7 hours with the polysomnographic(PSG) monitoring The 76 patients with moderate to severe OSAHS according to the PSG results were divided into“nCPAP group”(n=29) who underwent nCPAP therapy and“non- nCPAP group”(n=47) who did not undergo nCPAP therapy. Ten patients were excluded from the follow-up study for private reasons . The assessment protocol was then repeated after 3 months . Results (1) There were no significant differences of the serum level of T between simple snores and control group. The serum level of T was significantly lower in OSAHS patient than in the control group . (2) the serum level of T was negatively correlated with AHI,BMI,ages (r = --0.589 p<0.01;r = --0.225 p<0.05; r = -0.454 p<0.01)with Liner regression analysis,and the T level was positively correlated with SaO2(r =0.459 p<0.01). (3) After 3 months’nCPAP therapy in OSAHS patients, the serum level of T was significantly increased( p<0.01),w hile there were no similar changes in OSAHS patients without nCPAP therapy(p>0.05). Conclusion OSAHS patients have lower level of T. The serum level of T was negatively correlated with AHI、BMI. The serum level of T may be increased by nCPAP therapy in moderate to severe OSAHS patients.
引文
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[2]王广华.阻塞性睡眠呼吸暂停低通气综合征的临床表现.中华结核和呼吸杂志,2003,5:262-263.
[3]黄席珍.睡眠呼吸暂停综合征新认识.医学理论和实践,1997,9:385- 387.
[4] Gambineri A,Pelusi C,Pasquali R.Testosterone 1evels in obese male patients with obstructive sleep apnea syn drome: telation to oxygen desaturation,body weight,fat distribution and the metabolic parameters[J].J Endocrinol Invest, 2003,26(6):493-498.
[5]陈亮.衰老的Leydig胞中睾酮合成降低的机制.中国男科学杂志,2004,18(3):60-61.
[6]张颖,张立.血睾酮与运动.武汉体育学院学报, 2005年3月,第39卷第3期:58.
[7] Lv HS. Wu SZ.J First Mil Med Univ2001;21(5):387-389
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