阻塞性睡眠呼吸暂停综合征合并原发性高血压肾素-血管紧张素-醛固酮系统的变化研究

目的探讨肾素-血管紧张素-醛固酮系统(RAAS)在阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压发病机制中的作用。方法 2006年3月至2008年6月根据整夜多导睡眠监测(PSG)、血压测量和病史采集收治的天津医科大学总医院93例受试者分为OSAS血压正常组、OSAS高血压组、非OSAS高血压组、正常对照组。测定PSG当晚睡眠前后血压、血浆肾素活性(PRA)、血管紧张素Ⅱ(ATⅡ)、醛固酮(ALD)。结果 OSAS组不论有无高血压,晨起血浆PRA和ATⅡ均显著高于睡前,OSAS高血压组升高更明显;醒后PRA、ATⅡ与醒后平均动脉压(MAP)、睡眠呼吸暂停低通气指数(AH I)、最长呼吸暂停时间、呼吸暂停总时间、氧减饱和指数、睡眠期间血氧饱和度低于90%的时间占总睡眠时间的百分比(T90)呈显著正相关,与夜间最低血氧饱和度(m inSaO2)和平均血氧饱和度(MSaO2)呈负相关。结论 OSAS可引起肾素、血管紧张素分泌增多,提示RAAS在OSAS患者夜间一过性血压升高和持续性高血压形成方面可能起重要作用。

Role of renin-angiotensin-aldosterone system in pathogenesis of hypertension in patients with obstructive sleep apnea syndrome

Objective To explore the role of renin-angiotensin-aldosterone system(RAAS)in the pathogenesis of hypertension in patients with obstructive sleep apnea syndrome(OSAS).Methods Based on polysomnography(PSG),blood pressure(BP)and disease history,93 subjects were divided into four groups:OSAS without hypertension(A),OSAS with hypertension(B),hypertension without OSAS(C),normal control group(D).In addition to the blood pressure measurement,blood samples were collected before and after sleep during the PSG testin...