睡眠呼吸暂停综合征患者尿尿酸、心钠素、肾素醛固酮的变化及意义  

Significance of the changes of urinary uric acid, ANP, renin and aldosterone in sleep apnea syndrome patients

作　　者：肖永龙[1] 殷凯生[2] 郑培德[1] 戴令娟[1] 杭美琴[1] 朱世均 侯杰[1] 

机构地区：[1]南京大学医学院附属鼓楼医院呼吸科,南京210008 [2]南京医科大学第一附属医院呼吸科

出　　处：《中华结核和呼吸杂志》2000年第1期27-30,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　通过对睡眠呼吸暂停综合征 (SAS)患者的尿尿酸变化与夜间呼吸紊乱的关系及经鼻持续气道正压 (nCPAP)对其影响的研究 ,寻找一种监测nCPAP长期疗效的简便有效的方法。同时研究SAS患者的心钠素 (ANP)、肾素、醛固酮水平的变化及nCPAP治疗与SAS的夜间多尿的关系。方法　选取经多导睡眠图 (PSG)确诊为SAS的患者 2 2例为试验组 ,11名PSG检查正常者为对照组 ,13例重度SAS患者接受nCPAP治疗为治疗组 ,比较试验组与对照组 ,治疗组治疗前后的各项指标的差异。结果　 (1)Δ尿尿酸 /尿肌酐 :试验组 0 4 7± 0 3 1,明显高于对照组的 0 0 1± 0 2 3 (P <0 0 5 ) ,nCPAP治疗后 0 0 1± 0 19比治疗前 0 4 8± 0 2 7明显下降 (P <0 0 0 1) ;(2 )晨尿尿酸分泌 :试验组 (5 4± 2 3 )mg/L ,明显高于对照组 (3 2± 1 4 )mg/L(P <0 0 5 ) ,nCPAP治疗后 (3 3± 1 2 )mg/L比治疗前(5 9± 2 6)mg/L明显下降 (P <0 0 0 1) ;(3 )晨血心钠素 :试验组 (0 182± 0 0 0 4 ) μg/L ,明显高于对照组(0 15 3± 0 0 0 4 ) μg/L(P <0 0 0 1) ,nCPAP治疗后 (0 12 2± 0 0 0 1) μg/L比治疗前 (0 180± 0 0 0 3 ) μg/L明显下降 (P <0 0 0 1) ;(4)夜尿量 :试验组 (64 4± 6 1)ml/h ,明显高于对照组 (5Objectives To assess the utility of urinary uric acid excretion and urinary uric acid/creatinine ratio as the marker of nocturnal respiratory disturbance in patient with sleep apnea syndrome (SAS) before and after the institution of nasal continuous positive airway pressure (nCPAP) Another purpose is to explore the relationship between the nocturnal diuresis and atrial natriuretic peptide (ANP),renin aldosterone in SAS Methods 22 cases diagnosed as SAS by polysomnography (PSG) were selected as trial group , 11 cases excluded from SAS by PSG were as control group, and 13 severe SAS patients were treated by nCPAP and taken as nCPAP therapy group The markers mentioned above were compared in these groups Results The overnight change in urinary uric acid/creatinine ratio in trial group is 0 47±0 31, which is significantly higher than that in control group (0 01±0 23), P <0 05, and in nCPAP therapy group after therapy (0 01±0 19) significantly lower than that before nCPAP therapy (0 48±0 27) , P <0 001 The morning urinary uric acid excretion in trial group is (5 4±2 3) mg/L which is also significantly higher than that in control group (3 2±1 4) mg/L, P <0 001, and in nCPAP therapy group (3 3±1 2) mg/L significantly lower than that before nCPAP (5 9±2 6) mg/L, P <0 05 The mean morning blood ANP in trial group is (0 182±0 004) μg/L, which is higher than that in control group (0 182±0 004) μg/L, P <0 05,and in nCPAP therapy group (0 122±0 001) μg/L is much lower than that before nCPAP therapy (0 180±0 003) μg/L, P <0 001 However there are no statistic significant differences between these groups in blood renin aldosterone Conclusions The urinary uric acid excretion and overnight change in urinary uric acid/creatinine are good markers to determine the effects of nCPAP on SAS The nocturnal diuresis in SAS patients is correlated with the increase of ANP in plasma

关 键 词：呼吸暂停综合征 心钠素 尿酸 NCPAP 睡眠性 

分 类 号：R563.9[医药卫生—呼吸系统]