南方医科大学学报2016，Vol.36Issue(3)：339-344,6.DOI:10.3969/j.issn.1673-4254.2016.03.08
重度阻塞性睡眠呼吸暂停低通气综合征患者启动早期肾损害
Severe obstructive sleep apnea-hypopnea syndrome with latent renal dysfunction:analysis of 238 cases
摘要
Abstract
Objective To evaluate the association between severity of obstructive sleep apnea hypopnea syndrome (OSAHS) without chronic kidney disease (CKD) and serum cystatin C. Methods A total of 238 patients with snoring during sleep admitted between January 2012 and June 2015 underwent full-night polysomnography for diagnosis of OSAHS. The patients were divided according to the apnea-hypopnea index (AHI) scores into simple snoring group (AHI<5) and mild (AHI, 5-15), moderate (AHI, 15-30), and severe OSAHS (AHI>30) groups. The medical history, baseline demographic characteristics, blood glucose, blood lipids, peripheral blood cell count and serum cystatin C were measured, and the correlation between polysomnographic parameters and serum cystatin C were analyzed in different groups. Results The simple snoring, mild, moderate, and severe OSAHS groups consisted of 41, 49, 56, and 92 cases, respectively. Serum cystatin C, WBC and its subtype counts, RBC count, and superoxide dismutase (SOD) were all significantly higher in severe OSAHS group than in the other 3 groups (P<0.05), but serum creatinine and estimated glomerular fi ltration rate were comparable among the groups (P>0.05). Linear correlation analysis revealed that serum cystatin C was positively correlated with gender, BMI, neck circumference, abdominal circumference, SBP, AHI, and WBC (P<0.01) and inversely correlated with the average pulse oxygen saturation (ASpO2), minimum pulse oxygen saturation (MSpO2), and SOD (P<0.01). Multiple regression analysis identified AHI and SOD as independent factors that were positively and inversely correlated with serum cystatin C (β=0.218, P<0.010; β=-0.217, P<0.009), respectively. Conclusion Severe OSAHS is closely correlated with serum cystatin C, WBC, and SOD, suggesting that severe OSAHS may initiate the pathological process of early renal damage possibly in association with chronic intermittent hypoxia-induced oxidative stress and the initiation of the inflammatory cascade.关键词
阻塞性睡眠呼吸暂停低通气综合征/血清胱抑素C浓度/外周血白细胞计数/超氧化物歧化酶Key words
obstructive sleep apnea-hypopnea syndrome/serum cystatin C/white blood cell count/superoxide dismutase引用本文复制引用
蒋倩,李涛平,庞礡,王啸,王玉峰..重度阻塞性睡眠呼吸暂停低通气综合征患者启动早期肾损害[J].南方医科大学学报,2016,36(3):339-344,6.基金项目
国家“十二五”科技支撑计划（2012BAI05B030）Supported by National"Twelth Five-year plan"for Sci&Tech Research (2012BAI05B030) （2012BAI05B030）
