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目的 探讨肾脏病与睡眠呼吸暂停综合征 (SAS)的关系及临床意义。方法 对 1997年 1月～ 2 0 0 2年 1月肾脏病人 2 2 8例中 ,合并SAS的 18例病人进行回顾性分析 ,探讨二者的关系。结果 2 2 8例肾脏病人中合并SAS 18例 ,分别表现为无症状性蛋白尿 3例、肾病综合征 1例 ,糖尿病肾病 1例、慢性肾小球肾炎 2例、高血压肾损害 2例、终末期肾病 7例、肾小管功能障碍 2例。 13例病人给予药物和 /或经鼻面罩持续气道正压通气 (CPAP)治疗 ,SAS改善后 ,除终末期肾病病人外 ,余患者肾脏病均不同程度好转。 7例慢性肾功能衰竭病人中 2例死亡 ,2例改行腹膜透析后SAS好转 ,3例肾移植后SAS消失。结论 SAS可导致或加重肾脏损害 ,临床可表现为肾小球和 /或肾小管损伤。终末期肾病病人易于合并SAS ,SAS可严重影响此类病人生存质量、生存率。SAS与肾脏病可相互影响形成恶性循环 ,需引起临床警惕。
Objective To investigate the relationship between renal disease and sleep apnea syndrome (SAS) and its clinical significance. Methods A retrospective analysis of 18 patients with SAS in 228 kidney patients from January 1997 to January 2002 was conducted to investigate the relationship between the two. Results There were 18 cases of renal disease complicated by SAS in 18 cases, showing asymptomatic proteinuria in 3 cases, nephrotic syndrome in 1 case, diabetic nephropathy in 1 case, chronic glomerulonephritis in 2 cases, hypertensive renal impairment in 2 cases, End-stage renal disease in 7 cases, 2 cases of renal tubular dysfunction. Thirteen patients received drug and / or nasal mask continuous positive airway pressure (CPAP) treatment. After improvement of SAS, nephropathy patients were all improved to some extent except for patients with end-stage renal disease. Two of the seven patients with chronic renal failure died of the disease. Two patients switched to peritoneal dialysis SAS improved, and three patients died of renal failure. Conclusion SAS can cause or exacerbate renal damage, which can be clinically manifested as glomerular and / or tubular damage. End-stage renal disease patients with easy to merge SAS, SAS can seriously affect the quality of life of such patients, survival. SAS and kidney disease can affect each other to form a vicious cycle, to be caused by clinical vigilance.