慢性阻塞性睡眠呼吸暂停低通气综合征病情严重程度与心肌损伤及肾功能不全的关系

Correlation between myocardial damage,renal inadequacy and the desease severity in patients with chronic obstructive sleep apnea hypopnea syndrome

目的探讨慢性阻塞性睡眠呼吸暂停低通气综合征的严重程度与心肌损伤及肾功能不全的关系。方法对108例慢性阻塞性睡眠呼吸暂停低通气综合征患者和50例健康查体者进行呼吸暂停低通气指数、最低血氧饱和度的水平的检测,将患者分成轻、中、重组。计算各组心肌损伤、肾功能不色发生率,检测血清脂蛋白a、心肌肌钙蛋白Ⅰ及肌酐水平的变化。结果患者组与正常组比较血清脂蛋白a、心肌肌钙蛋白Ⅰ及肌酐水平明显增高,差异有统计学意义（P〈0.01）。患者组组间比较,差异有统计学意义（P〈0.01）。患者心肌损伤、肾功能不全的发生率52.78%、25.93%,并且随着病情严重程度分级的升高,心肌损伤、肾功能不全的发生率也在升高。结论随着病情严重程度分级升高,血清脂蛋白a、心肌肌钙蛋白Ⅰ及肌酐水平在升高,心肌损伤、肾功能不全的患病率也在升高,提示该病患者中心肌损伤、肾功能不全较常见。血清脂蛋白a、心肌肌钙蛋白Ⅰ及肌酐水平可以作为慢性阻塞性睡眠呼吸暂停低通气综合征病情严重程度的评价指标之一。

Objective To investigate the relationship between myocardial damage,renal inadequacy and the desease severity in patients with chronic obstructive sleep apnea hypopnea syndrome（OSASH）.Methods Based on the apnea-hypopnea index（AHI） and the minimum of saturation of blood oxygen（SaO2min）,108 patients with OSAHS were divided into three groups including mild,moderate and serious groups,and 40 healthy volunteers were chosen as control group at equal pace.Then the incidences of myocardial damage and renal inadequacy were computed,and the changes of Lp（a） cTnI and Cr were determined.Results Compared with control groups,levels of Lp（a）、cTnI and Cr in OSAHS groups were significantly higher.There was significant difference（P〈0.01）.Compared with different groups with OSAHS,there was aslo significant difference（P〈0.01）.The incidences of myocardial damage and renal inadequacy were 52.78% and 25.93% respectively,at the same time,the incidences increased with severity of OSAHS.Conclusion As the growing severity of OSAHS,the levels of Lp（a） cTnI and Cr go up step by step as well as incidences of myocardial damage and renal inadequacy.It shows that myocardial damage and renal inadequacy are quite common in patients with OSAHS,and Lp（a） cTnI and Cr could regard as one of the indexes to appraise the severity of OSAHS.