OSAHS夜间多尿患者血浆心房利钠肽水平的变化及临床意义

Plasma atrial natriuretic peptide levels in patients with obstruction sleep apnea hypopnea syndrome accompanied by nocturnal polyuria

目的探讨心房利钠肽（ANP）在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）夜间多尿患者中的变化及临床意义。方法选取OSAHS患者48例（伴夜间多尿23例，不伴夜间多尿25例）及同期体检健康者15例，均行多导睡眠图（PSG）监测，记录呼吸暂停低通气指数（AHI）、微觉醒指数（MAI）、氧减指数（ODI。）、血氧饱和度≤90％睡眠时间占总睡时间比例（SLT90％）。并记录24h尿量及夜尿量；采用放射免疫法测定血浆ANP水平。结果OSAHS伴夜间多尿患者ANP水平、AHI、ODI4、MAI、夜尿量以及夜尿次数均明显高于健康者及OSAHS不伴夜间多尿患者（P〈0.05或0．01）；OSAHS不伴夜间多尿组患者除夜尿量外的上述其他各项观察指标均明显高于对照组（P〈0．05或0．01）。夜尿量与AHI、ODI4、MAI均明显相关（P〈0．05或0．01），ANP与AHI、ODI4、MAI均显著正相关（均P〈0．01）。结论OSAHS患者睡眠间歇低氧及微觉醒是导致夜间多尿发生的主要原因，夜间多尿与OSAHS严重程度有关，血浆ANP水平可预测OSAHS夜间多尿的严重程度。

Objective To investigate the changes and clinicat significance of plasma atrial natriuretic peptide （ANP） levels in patients with obstruction sleep apnea hypopnea syndrome （OSAHS） accompanied by nocturnal polyuria. Methods Polysomnography （PSG） was performed in 22 OSAHS patients accompanied by nocturnal polyuria, 25 OSAHS patients without nocturnal polyuria and 15 healthy subjects; plasma ANP was measured by radioimmunoassay in all subjects and 24-h urinary volume was also recorded. Results The plasma ANP level in OSAHS patients accompanied by nocturnal polyuria was significantly higher than patients without nocturnal polyuria and healthy controls （P 〈 0.01 ）. The plasma ANP level and nocturnal urine volume were positively correlated with the index of AHI, ODI4 and MAI （P 〈0.01 ）, Conclusion Interval hypoxia and microarousal in OSAHS may be the cause of nocturnal polyuria, which is correlated with the severity of OSAHS. Plasma ANP level can be used to estimate the severity of nocturnal polyuria in patients with USAHS.