不同分期慢性肾脏病患者的阻塞性睡眠呼吸暂停综合征风险及影响因素研究  

The risk of obstructive sleep apnea syndrome and associated factors in different stages of chronic kidney disease patients

作　　者：黄卓 陈懿[1,2] 付平[1] 夏子敬 汤曦[1] HUANG Zhuo;CHEN Yi;FU Ping;XIA Zijing;TANG Xi(Department of Nephrology,West China Hospital,Sichuan University,Chengdu610041,China;Chronic Kidney Disease Management Center,West China Hospital,Sichuan University,Chengdu610041,China)

机构地区：[1]四川大学华西医院肾脏内科,四川成都610041 [2]四川大学华西医院慢性肾脏病管理中心,四川成都610041

出　　处：《西部医学》2019年第11期1700-1703,共4页Medical Journal of West China

基　　金：四川省科技支撑计划项目(2016FZ0117);四川大学青年教师科研启动基金(2017SCU11070)

摘　　要：目的应用简易睡眠呼吸评估量表探索不同分期慢性肾脏病(CKD)患者的阻塞性睡眠呼吸暂停综合征(OSA)风险及影响因素。方法纳入2016年11月~2017年2月于四川大学华西医院肾脏内科门诊随访的CKD患者189例。比较患者的一般资料、生化指标并完成睡眠呼吸(STOP-Bang)量表评估。结果 CKD1~2期患者(96例)、CKD3~4期患者(59例)及终末期肾脏病(ESRD)患者(34例)经过STOP-Bang量表评估发现,OSA高风险111例,低风险78例。其中,CKD1~2期患者中高风险比例为45.8%(44/96),CKD3~4期中为69.5%(41/59),ESRD中为76.5%(26/34)。CKD3~4期与ESRD患者中OSA高风险比例较CKD1~2期患者明显升高(P<0.05)。多因素logistic回归发现,性别、年龄、CKD分期与体质指数(BMI)是OSA患病高风险的独立相关因素(P<0.05)。结论在CKD患者中OSA患病风险大,OSA患病风险与eGFR水平呈负相关。中晚期CKD患者中,OSA高风险患者比例明显增高。在临床工作中可根据性别、年龄、BMI及CKD分期对重点人群进行早期筛查及干预。Objective To determine the risk and associated factors of obstructive sleep apnea(OSA) in different stages of chronic kidney disease(CKD) patients using sleep respiration questionnaire. Methods 189 CKD patients went to West China Hospital for follow-up and completed sleep respiration questionnaire(STOP-Bang Questionnaire) were enroll in this observational study. The participants were divided into three groups CKD 1-2 stages(n=96), CKD 3-4 stages(n=59) and end stage renal disease(n=34) according to estimated glomerular filtration rate. SPSS22.0 software was utilized to evaluate the correlation between CKD and OSA. Results 111 patients were regarded as having positive symptoms for OSA, while the rest patients(n=78) were not. In CKD 1-2 stages, 44 patients(45.8%) had high risk for OSA. 41 patients(69.5%) and 26 patients(76.5%) had high risk for OSA in CKD 3-4 stages and end stage renal disease(ESRD), respectively. The proportions of high risk for OSA in CKD 3-4 and ESRD were both significantly higher than that in CKD 1-2 stages(P=0.004, P=0.002). Binary logistic regression illustrated that gender, age, different CKD stages and BMI were important factors that were associated with OSA in CKD patients(P<0.05).Conclusion CKD patients have higher risk for OSA. The risk of OSA increases as eGFR declines. In advanced CKD patients, the proportion of high risk OSA is enhanced significantly. It is necessary to routinely screen OSA in key population.

关 键 词：慢性肾脏病 阻塞性睡眠呼吸暂停综合征 高风险 患病率 

分 类 号：R692.5[医药卫生—泌尿科学]