nCPAP治疗重度OSAS合并高血压患者血浆尾加压素Ⅱ的研究

Changes of Urotensi-II of plasma in patients with severe obstructive sleep apnea syndrome complicated with hypertension before and after treatment by nCPAP

目的探讨经鼻持续气道正压通气(nCPAP)治疗重度阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压病患者尾加压素(U-II)在其过程中病理生理的作用及临床意义。方法采用放射免疫法分析30例患者经nCPAP治疗前后U-II的水平;采用夜间多导睡眠(PSG)监测患者治疗前后SaO2及夜间7h血压水平。结果治疗前、后患者血浆U-II的水平及SaO2分别为(9.01±1.0)pg/ml、(7.2±0.8)pg/ml,(51.2±3.64)%、(85.3±3.6)%,均有统计学意义(P<0.005);治疗前、后夜间7h平均收缩压及舒张压分别为(156.67±9.56)mmHg、(137.57±15.309)mmHg、(105.50±4.89)mmHg、(83.45±14.9)mmHg,均有统计学意义(P<0.001)。结论U-II的增高可能是重度阻塞性睡眠呼吸暂停综合征合并高血压病患者疾病发生、发展的重要因素,通过nCPAP治疗后可使患者血浆中血浆U-II的水平明显降低,氧饱和度改善,具有明显的临床疗效。

Objective To evaluate the clinical effects and significance of serum Urotensin II （U -II） in patients with severe obstructive sleep apnea syndrome （OSAS） complicated with hypertension before and after treatment by night continuous positive airway pressure （nCPAP）. Methods Total 30 patients with severe OSAS complicated with hypertension were enrolled. They treated with nC- PAP at night, and the contents of serum U - II were detected with radioimmunoassay before and after treatment. Meanwhile, the level of night blood pressure and arterial oxygen saturation （ SaO2 ） were detected. Results The levels of serum U - II and SaO2 were respectively 9.01 ± 1.0pg/ml, 7.2 ± 0.8pg/ml; 51.2 ± 3.64%, 85.3 ± 3.6% before and after treatment （ P 〈 0. 005 ）. 7 hours SBP, DBP in trial group were respectively 156.67 ± 9.56 mmHg, 137.57 ± 15.30 mmHg, 105.50 ± 4.89 mmHg and 83.45 ±14.9 mmHg before and after treatment （ P 〈 0.001 ）. Conclusion Increase of Urotensin II may be an important factor for occurrence and development of severe OSAS complicated with hypertension, and nCPAP can decrease the levels of U - II and increase SaO2 to treatment these patients.