Kev pw tsaug zog cuam tshuam hauv lub raum mob ntev Ⅳ

Prevalence ntawm OSA thiab CSA hauv CKD

In the general population, the overall prevalence of moderate to severe OSA (AHI>15) yog kwv yees li 10%, nrog rau qee qhov kev tshawb fawb qhia txog qhov muaj ntau tshaj li 23% ntawm cov poj niam thiab 49% ntawm cov txiv neej 75,76. Hauv CKD, qhov tshwm sim ntawm qhov nruab nrab mus rau OSA hnyav yog li ntawm 25% mus rau 57% thiab nce ntxiv nrog rau lub raum ua haujlwm tsis zoo (siab tshaj plaws hauv cov neeg mob lub raum tsis ua haujlwm ntawm kev lim ntshav) 13,77-80. Feem ntau ntawm CSA hauv CKD yog kwv yees li 10%, piv nrog<1% in the general population. The increased prevalence of sleep apnea in CKD is not explained by age, elevated BMI, or comorbidities, suggesting that the underlying renal disease itself may be the primary cause.

Nyem rau Cistanche rau mob raum

Cov teeb meem hauv kev txheeb xyuas kev pw tsaug zog apnea hauv CKD

Txawm hais tias muaj kev tshaj tawm ntau ntawm kev pw tsaug zog apnea, pw tsaug zog apnea feem ntau underestimated thiab underdiagnosed nyob rau hauv CKD85, tej zaum vim hais tias cov "ib txwm" muaj feem xyuam rau txoj kev loj hlob ntawm OSA nyob rau hauv cov pej xeem-hnub nyoog, txiv neej pw, thiab rog-tsis zoo li muaj feem xyuam nrog. nrog kev txhim kho ntawm OSA hauv CKD. Cov qhab nia ntawm kev soj ntsuam feem ntau siv los tshuaj xyuas OSA hauv cov pej xeem, xws li STOP-BANG Questionnaire, Berlin Questionnaire, thiab cov lus nug ntawm lub caj dab hloov, feem ntau yog raws li cov xwm txheej pheej hmoo thiab ua tsis zoo (tsawg dua thiab qhov tseeb) Hauv cov neeg mob CKD thiab lub raum tsis ua haujlwm. 86

Cov neeg mob nrog CKD thiab OSA muaj BMI qis dua li cov neeg mob uas tsis yog CKD nrog OSA. Hauv kev hloov pauv ntawm Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv, uas suav nrog 76 tus neeg mob nrog CKD thiab OSA thiab 380 OSA-match cov neeg mob, txawm hais tias tsis muaj qhov sib txawv ntawm hnub nyoog (53 ± 13 xyoo vs. 51 ± 13 xyoo, raws li. ) lossis txhais tau tias AHI (44.2 ± 27.7 vs. 44.2 ± 2.76, ntsig txog), cov neeg mob lub raum tsis ua haujlwm tau qis BMI (28.1 ± 5.3 kg / m2 vs. 33.0 ± 13.8 kg / m2; P=0.003 ) 84.

Tsis tas li ntawd, cov tsos mob tshwm sim ntawm OSA, xws li snoring thiab apnea, mob taub hau thaum sawv ntxov, thiab pw tsaug zog ntau heev rau nruab hnub, tsis pom tseeb hauv CKD thiab cov neeg raum tsis ua haujlwm nrog OSA 87. Qhov tseem ceeb, qhov nce ntxiv ntawm lwm yam kev pw tsaug zog hauv CKD, xws li insomnia thiab RLS, nrog rau kev pw tsaug zog tsis zoo thiab kev qaug zog nruab hnub yog qhov cuam tshuam ntxiv uas tsis muaj kev ywj pheej ntawm OSA lossis kev pw tsaug zog tsis zoo thiab cuam tshuam nrog lub nra ntawm lub raum. kab mob nws tus kheej, tshuaj, comorbidities, thiab dialysis. 88, 89 Muab hais tias muaj kev pw tsaug zog apnea yuav tsis pom tseeb hauv kev kho mob, thiab muab nws qhov muaj feem ntau thiab cuam tshuam rau kev mob thiab kev tuag, qhov qis dua rau PSG kev kuaj mob lossis kev tshawb fawb pw tsaug zog tau pom zoo rau cov neeg mob lub raum tsis ua haujlwm. 87

Kev cuam tshuam ntawm Pw tsaug zog Apnea ntawm Morbidity thiab Mortality hauv CKD

Hauv cov pej xeem, kev pw tsaug zog apnea tsis kho yog cuam tshuam nrog kev pheej hmoo siab ntawm cov kab mob plawv mus sij hawm ntev thiab kev tuag 90-95 vim yog hemodynamic, autonomic, thiab inflammatory kev tshwm sim ntawm apnea, intermittent hypoxia, thiab arousals 96 . Pw tsaug zog apnea kuj tseem ua rau kev pw tsaug zog tsis zoo, qaug zog nruab hnub, pw tsaug zog ntev ntev, thiab txo qis kev ua haujlwm neurocognitive. Txawm hais tias cov ntaub ntawv pov thawj txuas rau kev pw tsaug zog apnea rau morbidity thiab kev tuag hauv CKD yog qhov txwv, ntau qhov kev tshawb fawb tau pom tias muaj kev pw tsaug zog apnea hauv cov pej xeem no cuam tshuam nrog kev qaug zog nruab hnub thiab txo lub neej zoo, nrog rau kev pheej hmoo siab ntawm plawv plawv. Cov xwm txheej thiab txhua qhov ua rau tuag, tsis hais seb puas tau lim ntshav los yog tsis siv. 97–99 Ib daim ntawv tshaj tawm xyoo 2020 ntawm kev tshawb fawb yav tom ntej ntawm 180 tus neeg mob CKD (92 ntawm cov neeg mob lub raum tsis ua haujlwm) nrog 9 xyoo kev soj ntsuam pom tau tias txawm hais tias qhov hnyav ntawm pw tsaug zog apnea (raws li AHI) tsis cuam tshuam nrog kev tuag ntau ntxiv. Tom qab hloov kho rau confounders, kev ntsuas ntawm nocturnal hypoxic lub nra-ib feem ntau ntawm lub sij hawm pw tsaug zog nrog oxygen saturation<90% and lower mean oxygen saturation-were significantly associated with higher mortality (HR, 1.4; 95% CI, 1.1 to 1.7; P = .007 for each 15% increase in the proportion of time with hyposaturation; and HR, 1.6; 95% CI, 1.2 to 2.1; P = .003 for each 2% decrease in mean oxygen saturation). 100

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rauraumnoj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tswv yim.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov nyhuv anti-inflammatory. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm lub cev thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.