持续气道正压治疗对阻塞性睡眠呼吸暂停患者夜间多尿症状的影响  

Effect of treatment with continuous positive airway pressure on nocturnal polyuria in patients with obstructive sleep apnea syndrome

作　　者：刘松[1] 刘立[1] 

机构地区：[1]江苏省徐州市第四人民医院呼吸科,徐州221009

出　　处：《中华结核和呼吸杂志》2001年第3期158-160,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　研究持续气道正压 (CPAP)治疗对阻塞性睡眠呼吸暂停综合征 (OSAS)患者夜间多尿症状的影响。方法　 15例多导睡眠图 (PSG)确诊的OSAS患者 ,记录CPAP治疗前后的夜尿次数、夜尿量、夜尿渗透压和夜尿钠排泄量 ,测定其中 8例患者治疗前后夜间 (2 3时、0 2时、0 5时 )心钠素(ANP)水平。结果　 (1)CPAP治疗后OSAS患者夜尿次数明显减少 (P <0 0 1)。 (2 )夜尿量由 (0 0 78± 0 0 17)L/h降至 (0 0 5 2± 0 0 11)L/h(P <0 0 1)。 (3)CPAP治疗后OSAS患者夜尿渗透压由 (381±96 )mmol/L明显增高至 (5 70± 16 9)mmol/L(P <0 0 5 )。 (4 )CPAP治疗后OSAS患者夜尿钠的排泄量由 (1 16± 0 35 )mmol/h降至 (0 6 3± 0 13)mmol/h(P <0 0 1)。 (5 ) 8例患者CPAP治疗前后的夜间ANP平均水平分别为 (146± 14)ng/L和 (10 6± 10 )ng/L ,两者相比差异有显著性 (P <0 0 1)。 (6 ) 8例测定ANP患者在CPAP治疗后ANP降低值与该患者夜尿量降低值、夜尿渗透压增高值、夜尿钠排泄量减少值均有显著的正相关 ,相关系数分别为 0 82、0 84、0 81(P均 <0 0 1)。结论　CPAP治疗可明显减少OSAS患者夜尿次数和夜尿量 ,减少夜尿钠排泄量 ,增加夜尿渗透压 。Objective To investigate the effect of treatment with continuous positive airway pressure(CPAP) on nocturnal polyuria in patients with obstructive sleep apnea syndrome(OSAS). Methods 15 patients with obstructive sleep apnea syndrome were included The number of nocturia, the nocturia output, the osmotic pressure of nocturia and the nocturia excretion of Na + were recorded Plasma levels of atrial natriuretic peptide (ANP) in night were measured in 8 patients After treatment with CPAP, all the criteria were repeated. Results (1) The number of nocturia decreased significantly after treatment with CPAP( P <0 01);(2) The difference between nocturia output pre and post treatment was significant ( P <0 01);(3) The osmotic pressure of nocturia rose from (381±96) mmol/L to (570±169) mmol/L( P <0 05);(4) The nocturia excretion of Na + droped from (1 16±0 35) mmol/h to (0 63±0 13) mmol/h( P <0 01);(5) Plasma levels of ANP in night decreased from (146±14) ng/L to (106±10) ng/L( P <0 01);(6) After treatment with CPAP, the reduction of ANP is correlated with the reduction of the nocturia output, the addition of the osmotic pressure of nocturia and the reduction of the nocturia excretion of Na + The correlation coefficients were 0 82,0 84,0 81 respectively. Conclusion Treatment with CPAP can reduce the number of nocturia, the nocturia output and the nocturia excretion of Na +, increase the osmotic pressure of nocturia The changes probably relate to the reduction of plasma level of ANP

关 键 词：阻塞性睡眠呼吸暂停综合征 持续气道正压呼吸 治疗 夜间多尿 

分 类 号：R766[医药卫生—耳鼻咽喉科]