阻塞性睡眠呼吸暂停综合征对Stanford B型主动脉夹层患者肾功能的影响

Effect of obstructive sleep apnea syndrome on renal function in patients with Stanford B aortic dissection

目的探讨阻塞性睡眠呼吸暂停综合征(OSAHS)对老年Stanford B型主动脉夹层肾功能的影响及可能机制。方法前瞻性收集住院的Stanford B型主动脉夹层患者157例,根据有无OSAHS分为单纯主动脉夹层组92例,OSAHS组65例,OSAHS组根据睡眠呼吸暂停低通气指数(AHI)分为轻度OSAHS组34例、中重度OSAHS组31例。抽血检测血清胱抑素C、肌酐、尿素、尿酸、β2微球蛋白,并分析其与AHI的相关性。结果 OSAHS组体质量指数、清晨高血压比例明显高于单纯主动脉夹层组[(27.7±4.6)kg/m2 vs(22.9±3.5)kg/m2,76.9%vs50.0%,P<0.05]。OSAHS组血清胱抑素C、尿素和β2微球蛋白水平明显高于单纯主动脉夹层组[(1.39±0.36)mg/L vs(0.86±0.34)mg/L,P<0.01;(5.82±1.32)mmol/L vs(5.16±1.22)mmol/L,P<0.05;(2.26±0.67)mg/L vs(1.87±0.45)mg/L,P<0.05]。中重度OSAHS组血清胱抑素C、尿素和β2微球蛋白明显高于轻度OSAHS组[(1.43±0.37)mg/L vs(0.93±0.32)mg/L,P<0.05;(5.93±1.34)mmol/L vs(5.25±1.26)mmol/L,P<0.05;(2.31±0.66)mg/L vs(1.89±0.44)mg/L,P<0.05]。Pearson相关性分析显示,血清胱抑素C(r=0.422,P=0.007)、β2微球蛋白(r=0.287,P=0.027)与AHI呈正相关。结论中重度OSAHS可预测老年Stanford B型主动脉夹层患者的肾功能。

Objective To study the effect of obstructive sleep apnea hypopnea syndrome（OSAHS）on renal function in elderly patients with Stanford type B aortic dissection and its mechanism.Methods One hundred and fifty-seven patients with Stanford B aortic dissection admitted to our hospital were divided into simple aortic dissection group（n=92）and OSAHS group（n=65）.The patients in OSAHS group were further divided into mild OSAHS group（n=34）and moderate OSAHS group（n=31）according to their AHI.Their serum levels of cystatin C,creatinine,urea nitrogen,UA andβ2-microglobulin were measured.Their correlation with AHI was analyzed.Results The BMI,incidence of morning hypertension,serum levels of cystatin C,creatinine,urea nitrogen,UA andβ2-microglobulin were significantly higher in OSAHS group than in simple aortic dissection group（P〈0.05）.The serum levels of cystatin C,urea nitrogen andβ2-microglobulin were significantly higher in moderate OSAHS group than in mild OSAHS group（P〈0.05）.Pearson correlation analysis showed that serum cystatin C andβ2-microglobulin levels were positively correlated with AHI（r=0.422,P=0.007;r=0.287,P=0.027）.Conclusion Moderate-severe OSAHS can predict the renal function in elderly patients with Stanford B aortic dissection.