【摘要】 目的:探讨夜间血浆脑钠肽及心钠素水平的变化对阻塞性睡眠呼吸暂停综合征obstructivesleepapneasyndrome,OSAS)患者夜间多尿的影(响,从而了解OSAS患者夜间多尿的原因。方法:选择2004-07/11武汉大学人民医院呼吸内科确诊为中重度OSAS并有夜间多尿的患者10例为实验组;选择同期本院健康体检正常人10例为对照组。记录OSAS患者的夜尿量、测定尿渗透压和尿钠水平,并用多导睡眠图(PSG)监测下,于22:00和6:00留取静脉血测定脑钠肽、心钠素水平,并与对照组比较。10例OSAS患者经经鼻持续气道正压通气nasalcontinuouspositiveairwaypressure,nCPAP)治疗后再次(进行上述检测。结果:①实验组治疗前22:00,6:00的脑钠肽水平犤(57.2±16.1),(60.3±18.9)μg/L犦均高于对照组犤(50.0±8.7),(50.9±9.8)μg/L犦,但差异无显著性意义(P>0.05);实验组经nCPAP治疗后脑钠肽水平无显著降低(P>0.05)。血浆脑钠肽水平与夜间尿量、尿渗透压及尿钠浓度无相关性r=0.067,-0.176,0.030,P>0.05)。②22:00时实(验组的心钠素水平与对照组比较,差异无显著性意义(P>0.05)。6:00时实验组的心钠素水平明显高于对照组(P<0.01),nCPAP治疗后心钠素明显下降(P<0.01)。血浆心钠素水平与夜间尿量、尿钠水平呈显著正相关(r=0.806,0.927,P<0.01),与尿渗?更多还原

【Abstract】 AIM:To investigate the relationship between nocturnal polyuria and the changes of brain natriuretic peptide(BNP) and atrial natriuretic peptide(ANP) levels in patients with obstructive sleep apnea syndrome(OSAS), so as to study the reasons for nocturnal polyuria of OSAS patients. METHODS:Ten patients(study group),who were diagnosed to have severe OSAS,and 10 healthy physical examinees(control group) in the Department of Respiratory Medicine,Renmin Hospital of Wuhan University during July and November 2004 were involved in this study.The nocturia output was recorded, the osmotic pressure of nocturia and the uric natrium(Na+ ) level were determined, and the venous blood was drawn at 22:00 and 6:00 respectively to measure the plasma levels of BNP and ANP under the monitoring of polysomnography(PSG),and the results were compared between the study group and control group.The above indexes were reexamined in the study group after treatment of nasal continuous positive airway pressure(nCPAP). RESULTS:① The plasma levels of BNP at 22:00 and 6:00 before treatment were insignificantly higher in the study group[(57.2± 16.1),(60.3± 18.9) μ g/L] than in the control group[(50.0± 8.7),(50.9 ± 9.8) μ g/L](P >0.05),and there was no significant decrease in the plasma BNP level of the study group after nCPAP treatment(P >0.05). Plasma levels of BNP had no correlation with the nocturia output, osmotic pressure of nocturia and uric Na+ level(r= 0.067,- 0.176,0.030,P >0.05).② The plasma level of ANP at 22:00 were not significantly different between the study group and control group(P >0.05),while that at 6:00 in the study group was obviously higher than that in the control group(P< 0.01),and the ANP level after nCPAP treatment was remarkably decreased(P< 0.01).Plasma level of ANP had significantly positive correlation with nocturia output and uric Na+ level(r=0.806,0.927, P< 0.01), but obvious positive correlation with osmotic pressure of nocturia(r=- 0.63,P< 0.05).CONCLUSION:OSAS cannot induce large excretion of BNP,but can lead to the significant increase of ANP,which is correlated with the nocturia output, osmotic pressure of nocturia and uric Na+ level.Treatment of nCPAP can decrease the plasma level of ANP, reduce the nocturia output, increase the osmotic pressure of nocturia and decrease the uric Na+ level.更多还原