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改善终末期肾病患者肾移植后的睡眠相关呼吸障碍。

Improvement of sleep-related breathing disorder in patients with end-stage renal disease after kidney transplantation.

机构信息

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Clin Transplant. 2011 Jan-Feb;25(1):126-30. doi: 10.1111/j.1399-0012.2009.01174.x.

Abstract

Sleep-related breathing disorder (SRBD) is a common symptom of end-stage renal disease (ESRD). The aim of this study was to determine whether kidney transplantation improves SRBD. Twenty-four patients with ESRD, who were admitted for kidney transplantation, underwent a sleep study using a portable ventilation effort recorder on the night before transplantation. Of these patients, 20 could repeat the overnight monitoring two wk after the transplantation. The median apnea-hypopnea index (AHI) of the 20 patients was 13.5 (range, 2-40), and significantly reduced to 4.5 (range, 0-20) after transplantation (p = 0.003). This reduction was most prominent in 12 patients with SRBD, for whom the median AHI fell from 22 (range, 10-40) to 6.5 (range, 1-20; p = 0.010). SRBD improvement, defined as an AHI equal to or >50% and/or reduced to <10/h, was observed in eight of the 12 apneic patients. These results suggest that kidney transplantation may immediately improve SRBD in patients with ESRD. However, conclusions from this study should be taken with caution because of the limitations of our method, specifically the use of a portable recorder and a small number of patients.

摘要

睡眠相关呼吸障碍(SRBD)是终末期肾病(ESRD)的常见症状。本研究旨在确定肾移植是否能改善 SRBD。24 名接受肾移植的 ESRD 患者在移植前一晚使用便携式通气努力记录仪进行睡眠研究。其中 20 名患者可以在移植后 2 周重复进行夜间监测。20 名患者的中位呼吸暂停低通气指数(AHI)为 13.5(范围为 2-40),移植后显著降低至 4.5(范围为 0-20)(p=0.003)。在 12 名有 SRBD 的患者中,这种降低最为明显,他们的中位 AHI 从 22(范围为 10-40)降至 6.5(范围为 1-20;p=0.010)。12 名呼吸暂停患者中有 8 名出现 SRBD 改善,定义为 AHI 等于或>50%和/或降至<10/h。这些结果表明,肾移植可能会立即改善 ESRD 患者的 SRBD。然而,由于我们方法的局限性,特别是使用便携式记录器和患者数量较少,应该谨慎得出本研究的结论。

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