OSA与肾功能关系的初步研究

宋凡; 易红良

doi:10.13201/j.issn.1001-1781.2019.04.004

OSA与肾功能关系的初步研究

宋凡,
易红良^,

- 上海交通大学附属第六人民医院耳鼻咽喉头颈外科上海交通大学医学院耳鼻咽喉科研究所(上海, 200233)

详细信息

通讯作者: 易红良,E-mail:18930172215@126.com

中图分类号: R563.8

收稿日期: 2018-11-20

Preliminary study on the relationship between OSA and renal function

SONG Fan,
YI Hongliang^,

- Department of Otolaryngology Head and Neck Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Otolaryngology Institute of Shanghai Jiaotong University, Shanghai, 200233, China

More Information

Corresponding author: YI Hongliang, E-mail: 18930172215@126.com

Received Date: 20 November 2018

摘要

摘要: 目的:探索OSA与肾功能的关系。方法:收集2013-01-2017-12期间行睡眠监测并排除慢性心脏病病史、急慢性肾小球肾炎、肾盂肾炎等病史的487例患者的临床资料。487例患者中,54例为对照组,433例为OSA组,其中轻度OSA组64例,中度OSA组77例,重度OSA组108例,极重度OSA组188例。采用肌酐及胱抑素联合计算公式估计肾小球滤过率(eGFR),并使用倾向得分匹配法来减小各组的差异,比较对照组与不同程度OSA组之间肌酐、胱抑素及eGFR的差异,分析OSA严重程度与肾功能损害的关系。结果:OSA组与对照组比较,肌酐水平差异无统计学意义。中度OSA组和极重度OSA组与对照组比较,血清胱抑素C水平较高[(0.90±0.18) mg/L、(0.82±0.21) mg/L,P=0.026;(0.92±0.22) mg/L、(0.82±0.21) mg/L,P=0.006],轻度OSA组和重度OSA组的胱抑素C与对照组相比差异无统计学意义。中度和极重度OSA组的eGFR与对照组相比较低(100.64±16.09、108.57±19.31,P=0.012;102.03±18.39、108.57±19.31,P=0.024)。用倾向得分匹配法进行匹配之后,中度和极重度OSA组与对照组比较,血清胱抑素C水平较高[(0.91±0.19) mg/L,(0.82±0.21) mg/L,P=0.028;(0.91±0.23) mg/L,(0.82±0.21) mg/L,P=0.031],但仅有中度OSA组eGFR与对照组相比较低(100.86±17.31、108.57±19.31,P<0.05)。结论:OSA患者的肾功能有不同程度的损伤,肾功能的损伤与OSA的严重程度并不呈单一的线性关系。
- 睡眠呼吸暂停 /
- 阻塞性 /
- 肾功能 /
- 胱抑素C
Abstract: Objective: To explore the relationship between obstructive sleep apnea(OSA) and renal function. Method: We collected the clinical data of 487 patients who underwent sleep monitoring in our hospital from January 2013 to December 2017 and excluded history of chronic heart disease, acute and chronic glomerulonephritis, and pyelonephritis. Among the 487 patients, 54 were in non-OSA control group and 433 were in OSA group, including 64 patients with mild OSA, 77 patients with moderate OSA, 108 patients with severe OSA, and 188 patients with extremly severe OSA. The eGFR was calculated using an equation combined serum creatinine and cystatin C. Then propensity score matching(PSM) was used to reduce differences in confounders among groups. The differences of creatinine, cystatin and eGFR between the control group and different degrees of OSA were compared, and the relationship between OSA severity and renal dysfunction was analyzed. Result: There was no statistically significant difference in creatinine between the OSA group and the control group. Serum cystatin C levels in the moderate OSA group and the extremly severe OSA group were higher compared with the control group,(0.90±0.18) mg/L,(0.82±0.21) mg/L, P=0.026;(0.92±0.22) mg/L,(0.82±0.21) mg/L, P=0.006, there was no statistically significant difference in cystatin C level of mild OSA group or severe OSA group compared with the control group.The eGFR levels in the moderate OSA group and extremly severe OSA group were lower than that in the control group, 100.64±16.09, 108.57±19.31, P=0.012; 102.03±18.39, 108.57±19.31, P=0.024. After matching with the PSM, the serum cystatin C levels in the moderate OSA group and in the extremely severe OSA group were higher compared with the control group,(0.91±0.19) mg/L, P=0.028;(0.91±0.23) mg/L, P=0.031;(0.82±0.21) mg/L, but only in moderate OSA group, eGFR was lower than the control group, 100.86±17.31, 108.57±19.31, P<0.05.Conclusion: The renal function of OSA patients has different degrees of impairment. Renal function impairment and the severity of OSA do not show a single linear relationship.
- sleep apnea /
- obstructive /
- renal function /
- cystatin C

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