阻塞性睡眠呼吸暂停低通气综合征对冠心病患者造影剂肾病发病率的影响

The Effect of Obstructive Seep Apnea Hypoventilation Syndrome on the Morbidity of Contrast-induced Nephropathy in Patients with Coronary Heart Disease

摘要:

目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对冠心病（CHD）患者造影剂肾病（CIN）发病率的影响。方法根据冠状动脉造影及多导睡眠监测的结果，将研究对象分为CHD无OSAHS组48例、CHD并OSAHS组62例，比较两组冠状动脉造影前后血清肌酐的变化及造影剂肾病的发病率。结果两组血清肌酐水平在冠状动脉造影前48h内差异无统计学意义（t＝－0.733，P＝0.465），冠状动脉造影和（或）经皮冠状动脉介入术后第1天、第3天CHD并OSAHS组血清肌酐水平高于CHD无OSAHS组，差异有统计学意义（t＝－2.486，P＝0.014；t＝－2.921，P＝0.004）。在纳入的研究对象中，18例发生CIN，总体CIN发生率为16.36%，其中CHD无OSAHS组4例，CIN发生率为8.33%，CHD并OSAHS组14例，CIN发生率为22.58%，两组患者CIN发病率差异具有统计学意义（χ²＝4.013，P＝0.045）。结论阻塞性睡眠呼吸暂停低通气综合征是冠心病患者造影剂肾病发生的一个相关风险因素。

关键词:阻塞性睡眠呼吸暂停低通气综合征;冠心病;造影剂肾病

Abstract:

Aim To investigate the effect of obstructive seep apnea hypoventilation syndrome （OSAHS） on the morbidity of contrast-induced nephropathy （CIN） in patients with coronary heart disease （CHD）.Methods 110 patients were divided into CHD without OSAHS group （n＝48） and CHD with OSAHS group （n＝62） according to diaognostic coronary angiography （CAG） and polysomnography （PSG）.Before and after coronary angiography or percutaneous coronary intervention （PCI）,the level of serum creatinine was compared between the two groups.The morbidity of CIN was compared between the two groups.Results The difference of the level of serum creatinine was not statistically significant between the two groups before coronary angiography （t＝－0.733,P＝0.465）.The difference of the level of serum creatinine was statistically significant between the two groups after coronary angiography or percutaneous coronary intervention （t＝－2.486,P＝0.014 t＝－2.921,P＝0.004）.The morbidity of CIN was higher in CHD with OSAHS group （χ²＝4.013,P＝0.045）.Conclusion OSAHS is a risk factor of CIN in patients with CHD.

Key words:Obstructive Seep Apnea Hypoventilation Syndrome Coronary Heart Disease Contrast-induced Nephropathy