阻塞性睡眠呼吸暂停综合征患者肾脏早期损害的观察
发布时间：2018-10-24 16:03
【摘要】：目的:研究阻塞性睡眠呼吸暂停综合征(OSAS)造成的肾脏早期损害。方法:选择OSAS患者180例,健康对照组60例均行多导睡眠监测仪(PSG)检查,根据呼吸暂停低通气指数(AHI)和夜间最低脉搏血氧饱和度(LSpO_2)的变化分为轻、中、重度三组,检测血清尿素氮(BUN)、血清肌酐(SCr)、血清胱抑素C(sCys C)、尿微量白蛋白/尿肌酐(UACR)、尿β_2微球蛋白(uβ_2-MG)、尿胱抑素C(uCys C)、尿肾损伤分子(uKIM-1)的水平,比较各组之间的差异。另外从中、重度组中各随机抽取30例患者进行持续正压通气(CPAP)治疗,1个月后复查相关指标并比较治疗前、后的变化。结果:OSAS各亚组的BUN、SCr、肾小球滤过率(GFR)水平较健康对照组无明显差异但重度OSAS组的sCys C水平较健康对照组、轻度组及中度组存在统计学差异。OSAS各亚组的UACR、uβ_2-MG、uCys C及uKIM-1水平均较对照组明显升高,各组间的uCys C及uKIM-1水平亦存在统计学差异。重度组UACR、uβ_2-MG水平明显高于轻、中度组但轻、中度组之间UACR、uβ_2-MG水平无统计学差异。OSAS患者AHI与uCys C及uKIMq水平存在显著相关性。中、重度OSAS患者CPAP治疗前后AHI、LSpO_2、sCys C、UACR、uβ_2-MG、uCys C及uKIM-1水平存在统计学差异,BUN、SCr、GFR水平无统计学差异。结论:OSAS患者早期肾功能损伤以肾小管损伤为主,UACR、uβ_2-MG、uCys C、uKIM-1及sCys C的变化早于BUN、SCr、GFR水平的变化,其中以uCys C及uKIM-1最为敏感,可作为评估OSAS早期肾脏损害的标志物。CPAP治疗可明显改善OSAS肾脏损害。
[Abstract]:Objective: to study the early renal damage caused by obstructive sleep apnea syndrome (OSAS). Methods: 180 patients with OSAS and 60 healthy controls were examined by polysomnography (PSG). According to the changes of apnea hypopnea index (AHI) and nocturnal minimum pulse oxygen saturation (LSpO_2), they were divided into three groups: mild, moderate and severe. The levels of urinary 尾 _ 2 microglobulin (u 尾 _ 2-MG), urinary cystatin C (uCys C), (C (uCys C),) and urinary renal injury molecule (uKIM-1) in serum urea nitrogen (BUN),) and serum creatinine (SCr),) were determined. In addition, 30 patients in the severe group were randomly selected for continuous positive pressure ventilation (CPAP) therapy. After one month, the related indexes were reviewed and the changes before and after treatment were compared. Results: there was no significant difference in BUN,SCr, glomerular filtration rate (BUN,SCr,) (GFR) level in each subgroup of OSAS compared with the healthy control group, but the sCys C level in the severe OSAS group was higher than that in the healthy control group. The levels of UACR,u 尾 _ 2-MGG uCys C and uKIM-1 in each subgroup of OSAS were significantly higher than those in the control group, and the levels of uCys C and uKIM-1 in each group were also significantly higher than those in the control group. The level of UACR,u 尾 _ 2-MG in severe group was significantly higher than that in mild group, moderate group but mild group, moderate group. There was no significant difference in UACR,u 尾 _ 2-MG level between severe group and moderate group. There was a significant correlation between AHI and uCys C and uKIMq levels in OSAS patients. In moderate and severe OSAS patients, there were significant differences in AHI,LSpO_2,sCys 尾 _ 2-MGG UCys C and uKIM-1 levels before and after CPAP treatment, but no significant difference was found in BUN,SCr,GFR level. Conclusion: renal tubular injury is the main type of renal function injury in the early stage of OSAS patients. The changes of UACR,u 尾 _ 2-MGUCys CnuKIM-1 and sCys C are earlier than that of BUN,SCr,GFR, and uCys C and uKIM-1 are the most sensitive. It can be used as a marker to evaluate early renal damage in OSAS. CPAP therapy can significantly improve renal damage of OSAS.
【作者单位】： 大连医科大学附属第二医院呼吸科;大连医科大学附属第二医院肾内科;
【基金】：十二五国家科技支撑计划课题(2011BAI10B08)
【分类号】：R766
，
本文编号：2291856
[Abstract]:Objective: to study the early renal damage caused by obstructive sleep apnea syndrome (OSAS). Methods: 180 patients with OSAS and 60 healthy controls were examined by polysomnography (PSG). According to the changes of apnea hypopnea index (AHI) and nocturnal minimum pulse oxygen saturation (LSpO_2), they were divided into three groups: mild, moderate and severe. The levels of urinary 尾 _ 2 microglobulin (u 尾 _ 2-MG), urinary cystatin C (uCys C), (C (uCys C),) and urinary renal injury molecule (uKIM-1) in serum urea nitrogen (BUN),) and serum creatinine (SCr),) were determined. In addition, 30 patients in the severe group were randomly selected for continuous positive pressure ventilation (CPAP) therapy. After one month, the related indexes were reviewed and the changes before and after treatment were compared. Results: there was no significant difference in BUN,SCr, glomerular filtration rate (BUN,SCr,) (GFR) level in each subgroup of OSAS compared with the healthy control group, but the sCys C level in the severe OSAS group was higher than that in the healthy control group. The levels of UACR,u 尾 _ 2-MGG uCys C and uKIM-1 in each subgroup of OSAS were significantly higher than those in the control group, and the levels of uCys C and uKIM-1 in each group were also significantly higher than those in the control group. The level of UACR,u 尾 _ 2-MG in severe group was significantly higher than that in mild group, moderate group but mild group, moderate group. There was no significant difference in UACR,u 尾 _ 2-MG level between severe group and moderate group. There was a significant correlation between AHI and uCys C and uKIMq levels in OSAS patients. In moderate and severe OSAS patients, there were significant differences in AHI,LSpO_2,sCys 尾 _ 2-MGG UCys C and uKIM-1 levels before and after CPAP treatment, but no significant difference was found in BUN,SCr,GFR level. Conclusion: renal tubular injury is the main type of renal function injury in the early stage of OSAS patients. The changes of UACR,u 尾 _ 2-MGUCys CnuKIM-1 and sCys C are earlier than that of BUN,SCr,GFR, and uCys C and uKIM-1 are the most sensitive. It can be used as a marker to evaluate early renal damage in OSAS. CPAP therapy can significantly improve renal damage of OSAS.
【作者单位】： 大连医科大学附属第二医院呼吸科;大连医科大学附属第二医院肾内科;
【基金】：十二五国家科技支撑计划课题(2011BAI10B08)
【分类号】：R766
，
本文编号：2291856
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