阻塞性睡眠呼吸暂停低通气综合征患者肾功能早期损伤的研究  

Study of early renal damage in patients with obstructive sleep apneahypopnea syndrome

作　　者：贺海霞 张帆[1] 袁琨[1] 陈伟[1] 蔡菁 吕凯 He Haixia;Zhang Fan;Yuan Kun(Wuhan Central Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院,武汉430014

出　　处：《临床内科杂志》2018年第12期813-815,共3页Journal of Clinical Internal Medicine

基　　金：武汉市卫计委资助项目(WX11C08).

摘　　要：目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)所致早期肾功能损伤的临床特点.方法 选取经多导睡眠监测(PSG)确诊为OSAHS的患者91例作为OSAHS组,随机选取健康成年人39例作为对照组.对患者进行整夜7 h监测,记录呼吸暂停低通气指数(AHI)和夜间最低脉氧饱和度(LSpO2).根据AHI和LSpO2不同,将OSAHS组分为轻、中、重度3个亚组.检测OSAHS组和对照组血清尿素氮(BUN)、血清肌酐(Scr)、胱抑素C(Cys C)水平并进行比较分析.结果 血清BUN、Scr在对照组和OSAHS各组间比较差异无统计学意义(P>0.05).OSAHS各组血清Cys C水平均明显高于对照组,且随病情程度加重而升高(P<0.01).OSAHS组血清Cys C与AHI呈正相关(r=0.428,P<0.01),与LSpO2呈负相关(r=-0.327,P<0.01),BUN与AHI、LSpO2无相关性(r=0.207,r=0.089,P>0.05);Scr与与AHI、LSaO2亦无相关性(r=0.215,r=0.097, P>0.05).结论 OSAHS可能引起早期肾功能损伤,OSAHS患者早期肾功能损伤以肾小球损伤为主,与OSAHS夜间反复低氧有关.Objective To study the clinical characteristics of early renal injury in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Ninety-one patients with OSAHS diagnosed by polysomnography(PSG)were chosen as OSAHS group.In addition,39 healthy adults were randomly chosen as control group.Patients were monitored for 7 hours at night to record apnea hypoventilation index(AHI) and lowest oxygen saturation (LSpO2)at night. According to the difference between AHI and LSpO2, OSAHS patients were divided into three subgroups:mild,moderate and severe group.The levels of blood urea nitrogen(BUN),serum creatinine (Scr)and Cystatin C (Cys C)were determined. Results No differences were found among OSAHS groups and control group in levels of BUN and Scr (P>0.05).The levels of Cys C in OSAHS groups were significantly higher than that in the control group and increased with the severity of OSAHS (P<0.01).The serum Cys C of OSAHS group was positively correlated with AHI(r=0.428,P<0.01),and negatively correlated with LSpO2(r= -0.327,P<0.01).There were no correlations between BUN,Scr and AHI,LSpO2.Conclusion OSAHS may cause early renal damage, and OSAHS has a significant effect on glomerular filtration function,which is related to repeated hypoxia in OSAHS at night.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 呼吸暂停低通气指数 最低脉氧饱和度 血清胱抑素C 肾功能 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]