中国全科医学2018，Vol.21Issue(19)：2319-2323,5.DOI:10.12114/j.issn.1007-9572.2018.19.010
不同肾功能分期的慢性肾脏病患者睡眠情况及其影响因素研究
Prevalence and Associated Factors of Sleep-disordered Breathing in Patients with Different Stages of Chronic Kidney Disease
封怡多 1龚勇 1张寅 1王冬雪 1丁霞 1吴昱 1张常勤 1周亦伦1
作者信息
- 1. 100050北京市,首都医科大学附属北京天坛医院肾内科
- 折叠
摘要
Abstract
Objective To evaluate the prevalence and associated factors of sleep-disordered breathing (SDB) in patients with different stages of chronic kidney disease (CKD).Methods A total of 132 inpatients from Department of Nephrology,Beijing Tiantan Hospital were enrolled during August 2016 to May 2017.We collected their baseline characteristics,laboratory test data,available parameters associated with sleep quality such as apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) derived from the automatic analysis of overnight sleep monitoring results (performed in the department) by Morpheus Ox web-based server software.Based on the definition of CKD and the eGFR level calculated by the modified CKD-EPI equation for Chinese populations with CKD,the patients were divided into non-CKD group,CKD 1-3 stages group,CKD 4-5 stages with dialysis group.Sleep quality was assessed by the Epworth Sleepiness Scale (ESS)and the Pittsburgh Sleep Quality Index (PSQI) .Statistical significance of the differences between three groups was tested using one-way ANOVA for continuous variables and χ2 test for categorical variables.Multivariable Logistic regression analysis was used to investigate the associated factors of moderate to severe SDB.Results The distribution of age and systolic blood pressure (SBP), percentages of hypertension history,and cardiovascular disease history differed significantly between the three groups (P＜0.05), while the distribution of sex,diastolic blood pressure (DBP) and body mass index (BMI),prevalence of smoking and alcohol consumption,percentage of diabetes history did not (P＞0.05).The distribution of eGFR,hemoglobin and albumin levels varied obviously between the three groups (P＜0.05),but that of total cholesterol and fasting blood glucose levels did not(P＞0.05).Three groups demonstrated similar mean AHI,similar percent of patients with an AHI≥15 and similar mean ESS score (P＞005),but significantly different mean ODI and PSQI (P＜0.05).The percent of patients with an ODI≥5 in CKD 4-5 stages with dialysis group was higher than that of non-CKD group (P＜0.017).The mean PSQI score was significantly higher in CKD 4-5 stages with dialysis group compared with that of other two groups (P＜0.017).Univariate Logistic stepwise regression analysis showed that age,hypertension,BMI and eGFR levelwere associated with mild to severe SDB (P＜0.05), and in multivariate regression analysis, BMI and eGFR level were independently associated with mild to severe SDB (P＜0.05). Conclusion Different mean ODI and PSQI in patients with different stages of CKD; decreased eGFR level as well as increased BMI were the risk factors for mild to severe SDB.关键词
肾病/睡眠呼吸暂停综合征/肾小球滤过率Key words
Nephrosis/Sleep apnea syndromes/Glomerular filtration rate分类
医药卫生引用本文复制引用
封怡多,龚勇,张寅,王冬雪,丁霞,吴昱,张常勤,周亦伦..不同肾功能分期的慢性肾脏病患者睡眠情况及其影响因素研究[J].中国全科医学,2018,21(19):2319-2323,5.
