睡眠呼吸暂停综合征患者经鼻持续气道正压治疗前后的尿尿酸分泌变化及意义

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 (nC PAP)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。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例PSG检查正常者为对照组 ,13例重度SAS患者进行nCPAP治疗 ,比较分析试验组与对照组 ,治疗前与治疗后的各项指标的差异。结果 :(1)△尿尿酸 /尿肌酐为 :试验组 0 .47± 0 .31,比对照组的0 .0 1± 0 .2 3明显增高 (P <0 .0 1) ,nCPAP治疗后 0 .0 1± 0 .19比治疗前 0 .48± 0 .2 7有明显下降 (P <0 .0 0 1) ;(2 )晨尿尿酸分泌为 :试验组 (5 .4± 2 .3)mg/L ,比对照组 (3.2± 1.4)mg/L明显增高 (P <0 .0 1) ,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 5 )。结论 :(1)尿尿酸分泌及△尿尿酸 /尿肌酐是判断nC PAP治疗效果的一项较为简便、有效的指标

SIGNIFICANCE OF THE CHANGES OF URINARY URIC ACID IN SAS AND THE EFFECTS OF TREATING WITH NCPAP

Objective 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). Method22 cases diagnosed as SAS by polysomnography (PSG) were taken as trial group , 11 cases excluded from SAS by PSG were taken as control group , and 13 severe SAS patients were treated by nCPAP and were taken as before nCPAP therapy group and after nCPAP therapy group . The markers above were compared in these groups .ResultThe overnight change in urinary uric acid /creatinine ratio in trial group is 0.47±0.31,and after nCPAP therapy group (0.01±0.19) significantly lower than before nCPAP therapy group (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 control group (3.2±1.4) mg/L, P<0.001, and after nCPAP group (3.3±1.2) mg/L significantly lower than before nCPAP group (5.9±2.6) mg/L,P<0.05. ConclusionThe urinary uric acid extretion and overnight change in urinary uric acid/creatinine are good markers to determine the effects of nCPAP on SAS.