阻塞性睡眠呼吸暂停综合征患者肾功能和电解质变化的研究

Changes of renal function and electrolytes in patients with obstructive sleep apnea syndrome

目的 :探讨阻塞性睡眠呼吸暂停综合征(Obstructivesleepapneasyndrome,OSAS)患者肾功能和体内电解质的变化。方法 :选择年龄、体重、身高、体重指数匹配的正常对照14名和OSAS患者14名 ,分别测定其血、尿中电解质、肌酐、渗透压 ,尿 β2 微球蛋白(β2 mG) ,血浆心钠素(ANF) ;计算出内生肌酐清除率和自由水清除率。结果 :OSAS组夜间尿K +非常显著地高于日间 ;其尿Na +、Cl -昼夜均较正常组非常显著地增多 ;其自由水清除率(CH2O)昼夜均显著高于正常组 ;其ANF夜间较正常组非常显著地增高 ,且其夜间亦较日间为高。结论 :OSAS患者夜间ANF分泌增多以及远端肾小管、收集管浓缩功能增强是这类患者夜间多尿 ,排Na +、K +、Cl -增多的原因。

Objective: To observe the changes of the renal function and water electrolyte balance in patients with obstructive sleep apnea syndrome (OSAS). Methods: In this study, 14 OSAS patients and 14 normal controls were selected. The 2 groups were matched for age, height, body mass and body mass index. Electrolytes, creatinine, osmotality in serum and urine, β2 microglobulin in urine and ANF in plasma were determined respectively. Ccr and CH2O were calculated. Results: All the parameters were significantly higher in OSAS patients than in the normal controls. Conclusion: The increase of ANF secretion in OSAS patients during sleep and the enhancement of concentrating capacity of the distal tubules and collecting ducts are the reason for diuresis and increased urinary Na+, K+ and Cl- excretion.