目的探讨老年阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea／hyponea syndrome，OSAHS）胰岛素抵抗和脂联素水平的相关性。方法2008年9月至11月在华山医院老年科因打鼾就诊的老年人共82例，根据多导睡眠图（polysomnography，PSG）结果分为单纯鼾症组（23例）和OSAHS组（59例）。测定空腹血搪（FBG）、血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C），空腹胰岛素（Fins）和脂联素（adiponectin，APN），计算胰岛素抵抗指数（homeostasis model assessment for estimating insulin resistance．HOMA—IR）值。比较单纯鼾症组和OSAHS组的一般资料，代谢参数以及合并症（高血压、冠心病、高脂血症、脑血管疾病和糖尿病）的患病率；分析睡眠呼吸紊乱指标和APN及HOMA—IR等代谢指标的相关性。结果1．OSAHS组的体质指数（BMI），腰罔和TG明显高于单纯鼾症组，HDL低于单纯鼾症组。高血压、高脂血症、糖尿病和脑血管疾病的患病率在OSAHS组升高。2．OSAHS组的FBG，Fins，HOMA—IR水平升高，APN降低。3．相关分析显示HOMA—IR与BMI，腰围，呼吸暂停低通气指数（AHI），氧减饱和指数（ODI），SaO2〈90％（％TST）呈正相关，与LSaO2呈负相关。4．相关分析显示APN与BMI，腰围，Fins，HOMA-IR呈负相关；与AHI，ODI，SaO2〈90％（％TST）呈负相关，与LSaO2呈正相关。结论本研究证实OSAHS患者肥胖、糖脂代谢紊乱和脑血管疾病的患病率高于对照组，胰岛素抵抗程度增高，APN水平降低。夜间间断性低氧和胰岛素抵抗及APN相关。
The Ageing delaying effects of Chinese herb medicines which possess the properties of BuShenYiJing on nucleic active genes and RNAase activity of old mice Zhuo Qin, Xu Qi, Zhang Jie et al Beijing Institute of TCM, Beijing 100010 The effects of BuShenYiJing medicine on liver nucleic active genes, serum Ribonuclease and blood SOD activities of old mice were studied in order to explore the delaying ageing molecular mechanism of BuShenYiJing medicine. The results indicate that there are pronounced elevation of digest sensitivity to active gene probe DNAase I of Nuclei and blood SOD activity and decline of serum RNAase in young group vs old group. The BuShenYiJing medicine can raise the digest activity to DNAase I of liver nuclei and the activity of blood SOD, and decrease the activity of serum RNAase of old mice. It may be one of the delaying ageing molecular mechanisms of BuShenYiJing medicine that they raise the liver nuclear active genes amount, blood SOD activity and decrease the serum RNAase activity. Key words BuShenYiJing Delaying ageing Active genes RNAase
