阻塞性睡眠呼吸暂停综合征患者血浆AVP水平变化

目的探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者血浆精氨酸升压素（AVP）水平变化和气道正压通气治疗的干预作用。方法61例受试者接受多导睡眠监测，其中17例患者给予自动调节持续气道正压通气（auto—CPAP）压力滴定，随机选择8例患者行双水平气道正压通气短期治疗。结果血浆AVP与呼吸暂停／低通气指数、氧减指数、微觉醒指数正相关，与最低血氧饱和度负相关；第一夜auto-CPAP滴定后和短期治疗后OSAS患者的应激事件和血浆AVP水平较滴定前均显著下降。结论OSAS患者的应激事件使血浆AVP释放增加，可能调节下丘脑-垂体-肾上腺皮质轴活性，参与OSAS病情发生；气道正压通气治疗可减少OSAS患者的应激事件，下调血浆AVP水平。

Chang of plasma AVP level in patients with obstructive sleep apnea syndrome

Objective To investigate the change of plasma AVP level in patients with obstructive sleep apnea syndrome(OSAS) and observe the intervention of the short-term positive airway pressure therapy. Methods sixty-one cases were examined by the polysomnography.The titration by auto-continuous positive airway pressure(auto-CPAP)was performed in seventeen patients with OSAS .Then eight cases were gave six days treatment by bi-level positive airway pressure(BiPAP).Results Plasma AVP was significantly positive correlated with apnea-hypopnea index,oxygen desaturation index, microarousal index and negative correlated with the nadir noctural oxygen saturation.The stress events and plasma AVP of OSAS decreased both after the first auto-CPAP titration and after the short-term treatment by BiPAP. Conclusion Stress events caused by OSAS increase the level of plasma AVP which are probably involed in activating the hypothalamic-pituitary-adrenal.The positive airway pressure therapy can be,therefore,a potential approach to reduce stress events of OSAS then to decrease the level of plasma AVP.