经鼻气道持续正压通气对OSAHS伴夜尿增多患者肾损伤的影响  

Effect of Nasal Continuous Positive Airway Pressure on Kidney Injury in OSAHS Patients with Nocturia

作　　者：郑艳文 钦光跃[2] 张颖[2] 陆晓玲[2] ZHENG Yanwen;QIN Guangyue;ZHANG Ying;LU Xiaoling(Department of Respiratory,the Xiaoshan First Affiliated Hospital of Hangzhou University Medical College,Hangzhou 311200,China)

机构地区：[1]杭州师范大学医学院附属萧山第一医院呼吸科,杭州311200 [2]浙江医院呼吸科,杭州310013

出　　处：《实用医学杂志》2018年第24期4120-4122,4126,共4页The Journal of Practical Medicine

基　　金：杭州市科技计划引导项目(编号:20171226Y90)

摘　　要：目的探讨经鼻气道持续正压通气(n-CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者肾功能影响作用。方法筛查出无肾脏疾病的中重度OSAHS合并夜尿增多患者35例,给予n-CPAP治疗一周,测定治疗前后夜尿量、夜尿次数、尿α1微球蛋白(α1-MG)、尿微量白蛋白(Alb)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、血清β2微球蛋白(β2-MG)、血肌酐(Scr)、尿IgG,对夜尿症状的改善与相关下降指标行相关分析。结果患者经n-CPAP治疗后较治疗前,夜尿量、夜尿次数、尿Alb、尿NAG、血Scr水平有明显下降(P <0.05),尿α1-MG及血β2-MG无明显下降,夜尿量和夜尿次数的改善与尿Alb、尿NAG呈正相关(P <0.05,<0.01),与其它指标相关性不明显。结论 n-CPAP能改善OSAHS伴夜尿增多患者肾损失,其缓解夜尿增多的治疗机制与改善肾功能有关。Objective To investigate the effect of nasal continuous positive airway pressure(NCPAP)onrenal functi on in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 35 pa-tients with moderate to severe OSAHS accompanied with increased nocturia and no renal disease were selected and treated with NCPAP for one week. The urine volume,nocturia,urine α1 microglobulin(α1-MG),and urinary traces were measured before and after treatment. Correlation analysis on improvement of nocturia symptoms and re-lated decline indicator such as Albumin(Alb),urinary N-acetyl-β-D-glucosaminidase(NAG),serum β2 micro-globulin(β2-MG),serum creatinine(Scr),urine IgG were conducted.Results After treatment with NCPAP,volume and frequency of nocturia,urine Alb,urinary NAG,and blood Scr levels were significantly decreased (P < 0.05). Urinary α1-MG and β2-MG were not significantly decreased. The decrease of volume and frequency of nocturia were positively correlated with urinary Alb and urinary NAG (P < 0.05,< 0.01),and were not signifi-cantly correlated with other indicators.Conclusions NCPAP could improve the renal loss in OSAHS patients with increased nocturia,and its therapeutic effect on relieving nocturia is related to the improvement of renal function.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 夜尿增多 肾损伤 经鼻气道持续正压通气 

分 类 号：R766[医药卫生—耳鼻咽喉科] R692[医药卫生—临床医学]