OSAHS血压正常患者肾素和醛固酮水平检测及评价

Detection and evaluation of renin and aldosterone levels in OSAHS patients with normal blood pressure

目的通过对血压正常阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清肾素、醛固酮水平变化的检测,分析OSAHS间歇性缺氧与肾素-血管紧张素-醛固酮系统(RAS)的关联性。方法选择在我院治疗的58例血压正常的OSAHS患者为观察组,选取同期58例门诊健康体检的非OSAHS健康人群为对照组,确保两组患者的一般资料(性别、年龄、醒时心率、醒时氧饱和度、血压、体重指数)及生化指标(谷丙转氨酶、谷草转氨酶、肌酐、尿素、红细胞比容)无显著差异(P>0.05)。统计两组研究对象AHI、最低血氧饱和度、夜间平均下降血氧饱和度、爱泼沃斯嗜睡量表(ESS)评分、血清醛固酮和肾素水平。结果观察组患者ESS评分均>10分;观察组AHI、夜间平均下降血氧饱和度、ESS评分均明显高于对照组,最低血氧饱和度低于对照组(P<0.05)。两组研究对象的血清醛固酮和肾素水平比较,差异无统计学意义(P>0.05)。结论OSAHS血压正常患者肾素和醛固酮水平与非OSAHS健康人群无显著差异;OSAHS患者的间歇性缺氧可能并不是激活RAS系统的直接因素,或者激活RAS系统还需要一定的条件。

Objective To analyze the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)intermittent hypoxia and renin-angiotensin-aldosterone system(RAS)by detecting the serum renin and aldosterone levels of OSAHS patients with normal blood pressure.Methods Fifty-eight OSAHS patients with normal blood pressure treated in our hospital were selected as observation group,58 healthy people of non-OSAHS underwent outpatient health examination in the same period were selected as control group,and it was ensured that there were no significant differences in general data(gender,age,heart rate in awake period,oxygen saturation in awake period,blood pressure,body mass index)and biochemical indexes(alanine aminotransferase,aspartate aminotransferase,creatinine,urea,hematocrit)between the two groups(P>0.05).AHI,lowest oxygen saturation,average decrease of nocturnal blood oxygen saturation,Epworth sleepiness scale(ESS)score,serum aldosterone and renin levels were counted.Results The ESS scores of the observation group were all more than 10 points;AHI,the average decrease of nocturnal blood oxygen saturation and ESS score of the observation group were significantly higher than those of the control group,and the lowest oxygen saturation was lower than that of the control group(P<0.05).There were no significant difference in serum aldosterone and renin levels between the two groups(P>0.05).Conclusion The levels of renin and aldosterone in OSAHS patients with normal blood pressure were not significantly different from those in non-OSAHS healthy people.Intermittent hypoxia in OSAHS patients may not be the direct factor to activate RAS system,or it needs certain conditions to activate RAS system.