中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (06): 385-388.doi: 10.3969/j.issn.1671-4091.2020.06.007

• 临床研究 • 上一篇    下一篇

维持性血液透析患者阻塞性睡眠呼吸暂停对二氧化碳结合力及左心室重构的影响

袁丹1,2,黄蓉3,李忠心1,李雪梅2,陈丽萌2,秦岩2   

  1. 1首都医科大学附属北京潞河医院肾内科.  中国医学科学院北京协和医学院北京协和医院2肾内科3呼吸科
  • 收稿日期:2020-02-04 修回日期:2020-04-15 出版日期:2020-06-12 发布日期:2020-06-24
  • 通讯作者: 秦岩 qinyanbeijing@126.com E-mail:yd155233380@sina.com

Effect of obstructive sleep apnea on carbon dioxide binding capacity and left ventricular remodeling in patients with maintenance hemodialysis

  1. 1Center for Kidney Disease, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China; 2Department of Nephrology and 3Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China
  • Received:2020-02-04 Revised:2020-04-15 Online:2020-06-12 Published:2020-06-24

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摘要： 【摘要】目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者发生阻塞性睡眠呼吸暂停(obstructive sleep apnea，OSA)的临床特点。方法对42 例MHD 患者进行夜间睡眠呼吸监测，将患者分为OSA 组31 例和非OSA 组11 例，再将OSA 组进一步分为轻度组(n=16)和中-重度组(n=15)。对比OSA 组与非OSA 组、轻度组与中-重度组间临床检测指标的差异。结果①OSA 组左心室向心性肥厚的发生率明显高于非OSA 组(c2=12.129,P=0.001)；②OSA 及中重度OSA 组患者的每日碳酸氢钠服用量分别高于非OSA 组及轻度OSA 组(t 值分别为-2.383、-2.448，P 值分别为0.022、0.021)。结论临床医生应关注MHD 患者OSA 的早期诊断和防治。不同于普通OSA 患者，该人群血清二氧化碳结合力与OSA 程度呈负相关，需要临床医生尤其关注碳酸氢钠的用量以纠正酸中毒。

关键词: 睡眠呼吸暂停, 维持性血液透析, 左心室重构, 二氧化碳结合力

Abstract: 【Abstract】Objective To explore the clinical characteristics of obstructive sleep apnea (OSA) in patients with maintenance hemodialysis (MHD). Methods Forty- two MHD patients were enrolled for night- time sleep breathing monitoring. They were divided into the OSA group (n=31) and the non-OSA group (n=11). The OSA group was further divided into a mild group (n=16) and a moderatEsevere group (n=15). The clinical characteristics between the four groups were compared. Results ①The incidence of left ventricular concentric hypertrophy was higher in OSA group than in non-OSA group (χ2=12.129, P=0.001). ②The daily sodium bicarbonate intake was higher in OSA group than in non-OSA group (t=-2.383, P=0.022), and was higher
in moderatEsevere OSA group than in mild OSA group (t=- 2.448, P=0.021). Conclusion Clinicians should pay attention to the early diagnosis and prevention of OSA in MHD patients. Unlike the OSA in general population, serum CO2CP is negatively correlated with the degree of OSA in MHD patients, suggesting that clinicians should concern about the amount of sodium bicarbonate to correct acidosis.

Key words: Sleep apnea, Maintenance hemodialysis, Left ventricular hypertrophy, Carbon dioxide binding capacity

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