摘要
目的探讨肾素-血管紧张素-醛固酮系统(RAAS)在阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压发病机制中的作用。方法 2006年3月至2008年6月根据整夜多导睡眠监测(PSG)、血压测量和病史采集收治的天津医科大学总医院93例受试者分为OSAS血压正常组、OSAS高血压组、非OSAS高血压组、正常对照组。测定PSG当晚睡眠前后血压、血浆肾素活性(PRA)、血管紧张素Ⅱ(ATⅡ)、醛固酮(ALD)。结果 OSAS组不论有无高血压,晨起血浆PRA和ATⅡ均显著高于睡前,OSAS高血压组升高更明显;醒后PRA、ATⅡ与醒后平均动脉压(MAP)、睡眠呼吸暂停低通气指数(AH I)、最长呼吸暂停时间、呼吸暂停总时间、氧减饱和指数、睡眠期间血氧饱和度低于90%的时间占总睡眠时间的百分比(T90)呈显著正相关,与夜间最低血氧饱和度(m inSaO2)和平均血氧饱和度(MSaO2)呈负相关。结论 OSAS可引起肾素、血管紧张素分泌增多,提示RAAS在OSAS患者夜间一过性血压升高和持续性高血压形成方面可能起重要作用。
Objective To explore the role of renin-angiotensin-aldosterone system （RAAS） in the pathogenesis of hypertension in patients with obstructive sleep apnea syndrome（OSAS）. Methods Based on polysomnography（ PSG）, blood pressure（BP） and disease history ,93 subjects were divided into four groups ： OSAS without hypertension （A） , OSAS with hypertension （B） , hypertension without OSAS （ C ） , normal control group （ D ）. In addition to the blood pressure measurement, blood samples were collected before and after sleep during the PSG testing night to measure renin,angiotensin and aidosterone level. Results Patients in A group and B group had significantly increased plasma PRA and AT Ⅱ value in the next morning compared with those before sleep and the change was more significant in B group compared to A group. Plasma PRA and AT ]] levels in OSAS with and without hypertension after sleep were positively correlated with mean arterial pressure （MAP） , apnea-hypopnea index （AHI） ,maximum apnea time,total apnea time,number of oxygen desaturation≥4% per hour（ODI4） ,percentage of time of oxygen saturation lower than 90% （T90） and negatively correlated with minimum arterial oxygen saturation（ minSaO2 ） and mean arterial oxygen saturation（ MSaO2 ）. Conclusion OSAS could stimulate RAAS excretion that may play an important role in the development of transient and sustained increase of blood pressure in patients with OSAS.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2011年第8期626-628,共3页
Chinese Journal of Practical Internal Medicine
基金
天津市科委自然科学基金资助项目(033611311)
