高血压病并发阻塞性睡眠呼吸暂停低通气综合征患者血浆肾素-血管紧张素Ⅱ-醛固酮的变化

目的: 探讨高血压病并发阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血浆肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）、醛固酮（Aldo）分泌异常的特点及其临床意义。方法: 高血压病并发OSAHS住院患者96 例,进行多导睡眠监测及其血浆PRA、AngⅡ及Aldo结果分析。根据睡眠呼吸暂停低通气指数(AHI)将研究对象分为轻度OSAHS组46例和中重度OSAHS组50例, 进行血浆PRA，AngⅡ及Aldo比较；并按年龄分层与单纯高血压病患者的PRA，AngⅡ及Aldo浓度比较。结果: 高血压病并发不同程度的OSAHS患者的血浆PRA，AngⅡ浓度比较无显著差异，中重度OSAHS组的Aldo浓度［(211±85)ng/L］较轻度组［(175±58)ng/L］明显升高(P<0.05);按年龄分层后与同血压水平的单纯高血压病比较，其不同年龄段的血浆PRA均明显降低(P<0.01),血浆Aldo浓度明显升高 (P<0.01)。结论: 高血压病并发OSAHS患者的血浆Aldo浓度明显升高，其血浆PRA，AngⅡ及Aldo浓度较单纯高血压病患者具有明显差异性。

Determination of plasma level of renin-angiotensin II-aldosterone in hypertensive patients with obstructive sleep apnea-hypopnea syndrome

AIM: To investigate the characteristics and level of renin-angiotensin II-aldosterone system in hypertensive patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Ninety-six hypertensive inpatients with OSAHS were included for polysomnography and quantitative analysis of plasma level of renin, angiotensin II and aldosterone. All subjects were divided into two groups based on the apnea-hypopnea index (AHI), one mild group with 46 cases and the other moderate-to severe group with 50 cases. Comparison of serum level of renin, angiotensin II and aldosterone was made between groups. All the above three parameters were compared among all included subjects based on age stratification. RESULTS: No significant difference in serum level of renin and angiotensin II was found between groups, whereas a significant difference was observed in aldosterone level ［(211±85) ng/L vs. (175±58) ng/L, P<0.05］. Significantly higher serum level of aldosterone and lower level of renin were found in hypertensive patients with OSAHS compared with those with simple hypertension based on age stratification (P<0.01). CONCLUSION: Serum level of aldosterone is significantly elevated in hypertensive patients with OASHS and serum levels of renin and aldosterone are also significantly higher than those of patients with simple hypertension.