睡眠呼吸暂停/低通气综合征患者心钠素变化及意义

The change and significance of atrial natriuretic peptide in the patient with sleep apnea/hypopnea syndrome

目的 探讨睡眠呼吸暂停 /低通气综合征 (SAHS)患者心钠素 (ANP)变化及意义。方法 根据多导睡眠图检查结果 ,将 90例患者分为正常对照组、轻度SAHS组和中重度SAHS组 ,用放免法测定各组早晨 6点血浆中ANP含量 ,中重度SAHS组经鼻持续气道正压通气 (NCPAP)治疗后再次测定血浆ANP含量。结果 轻度SAHS组ANP含量明显高于对照组 ,中重度SAHS组明显高于轻度SAHS组 ,分别为 (0 173± 0 0 0 4 )、(0 2 12± 0 0 0 4 )和 (0 2 6 8± 0 0 0 3) μg/L(P <0 0 1)。经NCPAP治疗后血浆ANP含量较前明显下降 ,为 (0 2 2 3± 0 0 0 1) μg/L ,与治疗前相比有显著性差异 (P <0 0 1)。结论 SAHS患者随呼吸紊乱指数的增高 ,血浆中ANP含量明显增高 ,NCPAP治疗后明显降低 ,提示ANP检测可作为评价SAHS严重程度和治疗效果的一种简便、可靠的辅助指标。

Objective To investigate the change and significance of atrial natriuretic peptide (ANP) in the patients with sleep apnea/hypopnea syndrome (SAHS).Methods 90 subjects were divided into three groups,ie,the normal group with AHI<5,the mild SAHS group with 5≤AHI<20,and the moderate/severe SAHS group with AHI≥20.The concentrations of ANP in the plasma sampled in the morning were measured with radio-immune assay.After the treatment of nasal continuous positive airway pressure(NCPAP) the concentration of ANP in the plasma from the moderate and severe group were measured again.Results The concentration of ANP in the mild SAHS group was markedly higher than that in the normal group but markedly lower than that in the moderate/severe group [(0.173 0.004),(0.212±0.004),and (0.268±0.003)μg/L( P <0.01),respectively].After the treatment of NCPAP,the concentration of ANP was decreased apparently [(0.223±0.001) vs (0.268±0.003)μg/L,respectively, P <0.01].Conclusions As the AHI score increased in the SAHS patients,the concentrations of ANP increased markedly which decreased obviously after the treatment of NCPAP.This indicates that the measurement of ANP concentration is a simple and reliable way to evaluate the degree of SAHS and the effectiveness of NCPAP treatment.