阻塞性睡眠呼吸暂停低通气综合征对肾小球滤过率及尿白蛋白与肌酐比的影响

目的了解阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)对蛋白尿及肾小球滤过功能的影响。方法采用回顾性研究方法收集222例OSAHS患者的人口学资料、实验室检测指标血肌酐、尿素氮、尿白蛋白与肌酐比(ACR)、血脂、血尿酸、空腹血糖、糖化血红蛋白、血红蛋白]及睡眠呼吸监测参数。将其中的OSAHS患者依据呼吸暂停低通气指数(AHI)分为3组,进行上述资料的比较。对肾小球滤过率及蛋白尿进行多元线性回归筛选独立预测因子。结果 OSAHS轻、中、重组对比,尿ACR差异有统计学意义(P=0.041),重度组明显高于轻度组(P=0.018)。多元线性回归分析提示eGFR的影响因素有糖尿病(P=0.026)、年龄(P=0.000)、肥胖(P=0.017)、血尿酸水平(P=0.044)。尿ACR的独立影响因素仅有收缩压(P=0.033)。结论 OSAHS严重程度不同,尿ACR有差异,重度组尿ACR明显高于轻度组。OSAHS不是肾小球滤过率及尿ACR的独立预测因子。

Glomerular filtration rate and proteinuria in obstructive sleep apnea syndrome patients

Objective To determine the relationship between OSAHS and glomerular filtration rate and proteinuria. Methods Retrospective evaluated the medical records of 222 subjects who were admitted for the polysomnography study. The differences in clinical characteristics among the severity of OSAHS were compared. Whether OSAHS was an independent risk factor for glomerular filtration rate(GFR) and proteinuria were analyzed. Results In patients with mild, moderate and severe OSAHS, ACR were different(P = 0.041). Patients with severe OSAHS had a significantly higher ACR than those with mild OSAHS(P = 0.018). Multiple regression analysis showed that diabetes mellitus(P = 0.026), age(P = 0.000), obesity(P = 0.017)and UA(P = 0.044) were independent predictors of eGFR, while the SBP(P = 0.033) was independent predictor of ACR. Conclusions In patients with mild, moderate and severe OSAHS, ACR are different. Patients with severe OSAHS have a significantly higher ACR than those with mild OSAHS.