阻塞性睡眠呼吸暂停综合征及其合并高血压患者血浆脑钠素水平的测定

Detection of plasma BNP levels in patients with obstructive sleep apnea hypopnea syndrome associated with hypertension

目的探讨阻塞性睡眠呼吸暂停综合征(OSAHS)及OSAHS合并高血压患者血浆脑钠素(BNP)的水平及其临床意义。方法健康对照组20例,单纯OSAHS组18例,OSAHS合并高血压组22例,60例患者均用Alice3多导睡眠监测仪或Startdust便携式睡眠监测仪进行多导睡眠图(PSG)检查及测量早晨空腹平静状态下血压。血浆BNP测定采用放射免疫分析法。结果单纯OSAHS及OSAHS合并高血压患者血浆BNP水平均高于正常对照组(P<0.05,P<0.01);且血浆BNP水平与单纯OSAHS、OSAHS合并高血压患者睡眠呼吸暂停(AHI)呈正相关(r=0.621,P<0.01;r=0.457,P<0.05),与SaO2<90%占总睡眠时间百分比呈正相关(r=0.517,P<0.05;r=0.612,P<0.01)。结论BNP参与了OSAHS的病理生理过程,血浆BNP水平升高可能对OSAHS的发生发展具有一定的保护作用,研究BNP水平对OSAHS病情的评估及指导治疗均有一定的意义。

Objective To investigate the role of brain natriuretie peptide （BNP） in the pathogenesis of hypertension in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods The levels of plasma BNP in 22 OSAHS patients complicated by hypertension, 18 simple OSAHS patients and 20 healthy subjects were measured by radioimmunoassay kit. Meanwhile the polysomnography （PSG） parameters were analyzed and the blood presures measured under peaceful fasting state in morning. Results The levels of plasma BNP were significantly higher in OSAHS patients complicated by hypertension and simple OSAHS patients than those in healthy subjects （ P 〈 0.05 or P 〈 0.01 ）. There was a positive correlation between the levels of plasma BNP and the apnea hypopnea index （AHI） in all the 40 OSAHS patients with or without hypertension （ r = 0.621, P 〈 0.01 ; r = 0.457, P 〈 0.05 respectively） .There was also a positive correlation beBveen the levels of plasma BNP and the SaO2 〈 90% in all the 40 OSAHS patients with or without hypertension （ r = 0.517, P 〈 0.05; r = 0.612, P 〈 0.01 respectively）. Condusion The plasma BNP is related with the pathophysiological process of OSAHS, the increased levels of plasma BNP may have the preventive effect on the pathogenesis and progress of OSAHS. The levels of OSAHS have the significance for the evaluation of OSAHS patient＇s condition and guidance of treatment at some degree.