OSAHS患者早期肾功能变化及临床意义  

Early Renal Injury in Patients with Obstructive Sleep Apnea- hypopnea Syndrome and Its Clinical Significance.

作　　者：詹冰洁[1] 钦光跃[2] 郑艳文[1] 张颖[1] 陆晓玲[2] 

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江医院呼吸科,杭州310013

出　　处：《医学研究杂志》2013年第9期76-79,共4页Journal of Medical Research

基　　金：浙江省医药卫生科学研究基金资助项目(2009A018)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者早期肾功能变化及临床意义。方法选择经多导睡眠图(polysomnography,PSG)监测并记录夜尿次数确诊的OSAHS伴或不伴夜间多尿患者各20例和健康对照者21例,分别测定其尿N-乙酰-β-D氨基葡萄糖酐酶(nacety-β-D-amino-glucosidase,NAG)、尿α1-微球蛋白(α1-microglobumin,α1-MG)、尿β2-微球蛋白(β2-microglobumin,β2-MG)、尿微量白蛋白、血胱抑素-C(cystatin-C,Cys-C)、血肌酐(serum creatinine,Scr)水平。结果 (1)OSAHS伴夜间多尿组和OSAHS不伴夜间多尿组患者尿NAG、尿α1-MG、尿β2-MG、血Cys-C及尿微量白蛋白水平(3.28±1.57U/mmol、15.31±9.17mg/L、2.30±0.41mg/L、1.59±0.43mg/L、19.95±20.89mg/L和2.60±1.02U/mmol、10.33±7.73mg/L、2.12±0.34mg/L、1.27±0.45mg/L、13.43±12.35mg/L)较健康对照组(2.27±0.72U/mmol、6.53±2.78mg/L、1.72±0.29mg/L、1.07±0.15mg/L、7.83±3.20mg/L)升高(P<0.01或P<0.05)。(2)OSAHS伴夜间多尿组患者尿NAG、尿α1-MG、血Cys-C水平(3.28±1.57U/mmol、15.31±9.17mg/L、1.59±0.43mg/L)较OSAHS不伴夜间多尿组(2.60±1.02U/mmol、10.33±7.73mg/L、1.27±0.45mg/L)升高(P<0.01或P<0.05)。(3)OSAHS患者尿NAG、血Cys-C与PSG参数(AHI、ODI4、MAI)存在正相关(r分别为0.493、0.316、0.461及0.417、0.343、0.436,P<0.01或P<0.05)。结论 OSAHS患者存在早期肾功能损伤,伴夜间多尿患者尤甚,且损伤程度与OSAHS严重程度相关。Objective To study the early renal injury in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） and the clinical significance.Methods Objects of the study were divided into three groups-OSAHS with nocutria（20 cases）,OSAHS without nocutria（20 cases） and healthy controls（21 cases） according to polysomnography（PSG） and recording numbers of night-time void.urine nacety-β-D-amino-glucosidase（NAG）,urine α1-microglobumin （α1-MG）,urine β2-microglobumin（β2-MG）,urine microalbumin,plasma cystatin-C（Cys-C） and serum creatinine（Scr） of all the objects were detected.Results （1） The levels of urine NAG,urineα1-MG,urineβ2-MG,plasma cys-C and urine microalbumin in group with Nocutria and group without Nocutria （3.28 ± 1.57U/mmol,15.31 ± 9.17mg/L,2.30 ± 0.41mg/L,1.59 ± 0.43mg/L,19.95 ± 20.89mg/L and 2.60 ± 1.02U/mmol,10.33 ± 7.73mg/L,2.12 ± 0.34mg/L,1.27 ± 0.45mg/L,13.43 ± 12.35mg/L） were significantly higher than levels in healthy controls （2.27±0.72U/mmol,6.53±2.78mg/L,1.72±0.29mg/L,1.07±0.15mg/L,7.83±3.20mg/L,P〈0.01 orP〈0.05）.（2）The levels of urine NAG,urineα1-MG and plasma Cys-C in group with nocutria（3.28 ± 1.57U/mmol,15.31 ± 9.17mg/L,1.59 ±0.43mg/L） were significantly higher than levels in group without Nocutria （2.60 ± 1.02U/mmol,10.33 ± 7.73mg/L,1.27 ± 0.45mg/L,P 〈 0.01 or P 〈0.05）.（3）The value of urine NAG and plasma Cys-C positively correlated with parameters of PSG（AHI,ODI4,MAI） in patients withOSAHS （r=0.493,0.316,0.461 and 0.417,0.343,0.436,P〈0.01 orP〈0.05）.Conclusion There is early renal injury in patients with OSAHS,especially in patients with Nocutria.The degree of injury is related to the severity of OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 夜间多尿 肾功能损伤 

分 类 号：R692[医药卫生—泌尿科学]