OSAHS患者早期肾损伤及n-CPAP对其影响
发布时间：2018-06-06 13:36
本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 早期肾损伤 ； 参考：《浙江中医药大学》2012年硕士论文
【摘要】：目的了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者是否存在早期肾损伤,观察n-CPAP治疗对其影响,初步探讨OSAHS患者早期肾损伤的发生机制 方法对30例OSAHS患者和30例健康体检者进行肾功能常规指标(Scr、BUN)和早期敏感指标(血胱抑素C、血β2-MG、尿mAlb、尿al-MG、尿NAG)测定,比较两组间的差异；对19例中重度OSAHS患者进行经鼻持续正压通气(n-CPAP)治疗,比较治疗前后各项指标的变化；分析从多导睡眠图仪(PSG)获得的参数(AHI、LSaO2、MSaO2、 MAI)与肾功能各指标间的相关性。 结果实验组Scr、BUN与对照组无显著性差异(73.36±11.14、73.11±5.9,2.5±0.41、2.39±0.48)(P0.05)；实验组血胱抑素C、血p2-MG、尿mAlb、尿al-MG、尿NAG明显高于对照组(1.32±0.38、0.91±0.19,2.23±0.42、1.78±0.29,19±16.34、7.49±3.06,14.56±8.51、6.34±2.69,2.99±1.44、2.21±0.60)(P0.01)；治疗组n-CPAP治疗后Scr、BUN、血p2-MG与治疗前无显著差异(73.77±13.52、72.65±11.56,2.51±0.45、2.46±0.42,2.33±0.42、2.25±0.43)(PO.05)；血胱抑素C、尿mAlb、尿α1-MG、尿NAG均较治疗前明显降低(1.23±0.41、0.95±0.20,18.72±14.68、11.15±8.67,15.40±9.27、10.39±5.8,3.12±1.68、2.14±0.80)(P0.01)；肾功能常规指标中Scr与MSaO2呈负相关(r=0.37); BUN与AHI呈正相关(r=0.42)；肾功能早期敏感指标中血胱抑素C、β2-MG、尿mAlb、尿al-MG、尿NAG与AHI呈正相关(r=0.600、0.591、0.564、0.524、0.586,P0.01)；与LSa02呈负相关(r=-0.556、-0.598、-0.600、-0.549、-0.515, P0.01)；与MSa02呈负相关(r=-0.545、-0.572、-0.557、-0.510、-0.493,P0.01);尿mAlb与.MAI呈正相关(r=0.392, P0.05)。 结论OSAHS患者存在早期肾损伤,n-CPAP治疗对改善OSAHS患者的肾功能有益,间歇低氧可能是OSAHS患者早期肾损伤的主要原因。
[Abstract]:Objective to investigate the early renal injury in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), observe the effect of n-CPAP treatment on it, and explore the mechanism of early renal injury in OSAHS patients. Methods 30 patients with OSAHS and 30 healthy controls were examined with routine renal function index (Scr-BUNE) and early sensitive indexes (cystatin C, serum 尾 2-MG, urinary mAlb, urine al-MG, urinary nag), and the difference between the two groups was compared. 19 patients with moderate and severe OSAHS were treated with nasal continuous positive pressure ventilation (OSAHS), and the changes of the indexes before and after treatment were compared, and the correlation between the parameters of AHIHIGH LSaO2MSaO2 (mai) and the renal function was analyzed. 缁撴灉瀹為獙缁凷cr,BUN涓庡鐓х粍鏃犳樉钁楁，
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