阻塞性睡眠呼吸暂停低通气综合征患者血清胱抑素C测定及临床意义

Determination of Serum Cystatin C in Patients with Obstructive Sleep Apnea-hyponea Syndrome and its Clinical Significance

目的:评价血清胱抑素C在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者肾损害中的诊断价值及不同程度OSAHS患者血清CysC水平的变化。方法:对45例OSAHS患者和15例健康成人进行多导睡眠图监测,应用颗粒增强散射比浊法、化学发光法、酶法和苦味酸法测定血清中CysC、β2G-MG、BUN、Scr和尿中的β2G-MG。结果:OSAHS组患者血清中CysC和尿β2G-MG显著高于健康对照组(P<0.05),OSAHS组血β2G-MG、BUN和SCr与健康对照组差异无显著性(P>0.05)。OSAHS重度组血清CysC较轻、中度组明显升高(P<0.05),OSAHS三组中尿β2G-MG组间差异有显著性(P<0.05),三组血β2G-MG、BUN和Scr差异无统计学意义(P>0.05)。结论:OSAHS患者存在早期肾损害,血清CysC和尿β2G-MG是反映早期肾损害的敏感指标。

Objective To evaluate the diagnostic value of cystatin C （CysC） in early renal impairment in patients with obstructive sleep apnea-hyponea syndrome（OSAHS） ,and to analyze the level changes of serum CysC in patients with OSAHS at different degree. Methods Forty-five patients with OSAHS and fifteen healthy control were monitered with polysomnography, the levels of CysC, β2 G-MG, BUN, SCr in serum and β2G-MG in urine were determined with particle enhanced nephelometric assay, chemiluminescence immunoassay, enzyme method and picric acid method, respectively. Results The levels of CysC in serum and β2G-MG in urine were significantly higher in OSAHS patients than that in healthy control（ P 〈 0.05 ）, while the serum levels of β2 G-MG, BUN and SCr had no significant difference between two groups （P 〉 0.05 ）. The level of serum CysC in severe group with OSAHS was significantly higher than that in moderate and mild group （ P 〈 0.05 ） . The levels of Urine β2G-MG were significantly different in severe,moderate and mild group（ P 〈 0.05 ） ,while the serum β2G- MG, BUN and SCr had no significant difference in three groups （ P 〉 0.05 ）. Conclusion Early renal impairment could be observed in patients with OSAHS, serum CysC and urine β2 G-MG may be sensitive indicators for the diagnosis of early renal impairment.