阻塞性睡眠呼吸暂停低通气综合征对患者肾功能的影响及其与痰湿证的关系研究

Effect of obstructive sleep apnea hypopnea syndrome on renal function and its relationship with phlegmdampness syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对患者肾功能的影响及其与痰湿证的关系。方法选取2017年5月至2019年1月于福建省立医院住院及门诊就诊期间行多导睡眠监测(PSG)患者174例,诊断为OSAHS的患者作为OSAHS组(113例),无OSAHS的患者作为非OSAHS组(61例)。比较2组患者的一般资料、血脂、空腹血糖、血尿酸、估算肾小球滤过率(eGFR)水平及PSG指标。采用Pearson相关性检验分析eGFR水平与OSAHS分度的相关性。采用Logistic回归方法分析OSAHS与肾功能、痰湿证的关系。结果OSAHS组体重指数、高血压及痰湿证比例、三酰甘油、血尿酸水平均高于非OSAHS组,eGFR水平低于非OSAHS组,差异均有统计学意义(均P<0.05)。OSAHS组脑电醒觉反应指数高于非OSAHS组[(25±16)/h比(14±8)/h],平均氧饱和度、最低氧饱和度均低于OSAHS组[(94.2±2.7)%比(96.4±1.5)%、(77±12)%比(90±5)%],差异均有统计学意义(均P<0.001)。Pearson相关性分析结果显示,eGFR水平与OSAHS分度呈负相关(r=-0.168,P=0.022)。Logistic回归分析结果显示OSAHS患者发生肾功能损伤风险增加2.245倍(95%置信区间1.003~5.028,P=0.049);痰湿证患者OSAHS发生风险增加1.539倍(95%置信区间1.028~4.827,P=0.046)。结论OSAHS患者肾功能受损风险增加,是慢性肾脏病的潜在危险因素,痰湿证患者OSAHS患病风险增加。

Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome(OSAHS) on renal function and its correlation with phlegm-dampness syndrome.Methods From May 2017 to January 2019,174 patients underwent polysomnography(PSG)during inpatient and outpatient treatment in Fujian Provincial Hospital were selected,including OSAHS 113 cases(OSAHS group)and without OSAHS 61 cases(non OSAHS group).The general data,levels of blood lipid,fasting blood glucose,serum uric acid and estimated glomerular filtration rate(eGFR)and PSG indexes were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between eGFR level and OSAHS grade.Logistic regression analysis was used to analyze the relationship between OSAHS and renal function and phlegm-dampness syndrome.Results The body mass index,proportions of hypertension,phlegm-dampness syndrome,levels of triacylglycerol and serum uric acid in OSAHS group were higher than those in non OSAHS group,and eGFR level in OSAHS group was lower than that in non OSAHS group(all P<0.05).Arousal index in OSAHS group was higher than that in the non OSAHS group[(25±16)/h vs(14±8)/h],and average oxygen saturation and minimum oxygen saturation in OSAHS group were lower than those in non OSAHS group[(94.2±2.7)%vs(96.4±1.5)%,(77±12)%vs(90±5)%](all P<0.001).The results of Pearson correlation analysis showed that there was a negative correlation between eGFR level and OSAHS grade(r=-0.168,P=0.022).Logistic regression analysis showed that the risk of renal function impairment in OSAHS patients was 2.245 times higher than that in patients without OSAHS[95%confidence interval(CI):1.003-5.028,P=0.049],and the risk of OSAHS in phlegm-dampness syndrome patients was 1.539 times higher than that in patients without phlegm-dampness syndrome(95%CI:1.028-4.827,P=0.046).Conclusions The risk of renal function impairment is increased in patients with OSAHS,which is a potential risk factor for chronic kidney disease.The risk of OSAHS in patients with phlegm-dampness syndrome is increased.