阻塞性睡眠呼吸暂停综合征肺动脉高压患者肾上腺髓质素、心钠素的变化

目的探讨阻塞性睡眠呼吸暂停综合征（OSAS）患者肺动脉高压的发生率及肺动脉高压变化与血浆中肾上腺髓质素（ADM）、心钠素（ANP）浓度变化间的关系。方法随机选择32例中老年健康者为对照组，确诊为OSAS者61例。用心脏B超测量其肺动脉压力，放射免疫分析法测定其血浆ADM和ANP浓度。结果61例OSAS中肺动脉高压26例，肺动脉高压发生率为42．6％。ADM浓度：OSAS非肺动脉高压与对照组相比差异有显著性（P〈0．05），肺动脉高压组与非肺动脉高压组及对照组差异均有显著性（P〈0．001）。ANP浓度：OSAS肺动脉高压组、非肺动脉高压组、对照组三者间比较差异有显著性（P〈0．001）。结论OSAS患者肺动脉高压发生率高。血浆ADM、ANP浓度与肺动脉高压的程度呈正相关。ANP参与了肺动脉高压的病理生理过程。

Changes of plasma ADM and ANP of pulmonary artery hypertension in patients with obstructive sleep apnea syndrome

Objective To explore the incidence of pulmonary artery hypertension (PAH) and changes of plasma adrenomedullin ( ADM) and atrial natriuretic polypeptide ( ANP) in patients with obstructive sleep apnea syndrome ( OSAS) . Methods 32 healthy middle- and elder-aged cases were randomly selected as control group, 61 cases were confirmed clinically with OSAS. The pressure of pulmonary artery was measured with real time gray scale two-dimensional ultrasonic tomography, the blood plasma levels of ADM and ANP were determined with radioimmunoassay method. Results Among 61 OSAS patients, 26 of them presented with PAH, its incidence in OSAS was 42. 6%. The plasma level of ADM in OSAS with non-PAH group had statistical difference compared with control group ( P < 0. 05 ) , also there were significant differences between PAH, non-PAH and control group ( P < 0. 001). Concurrently, the plasma level of ANP in OSAS with PAH, non-PAH also had significant differences compared with control group (P < 0. 001). Conclusions There was high incidence of PAH in OSAS patients. The plasma levels of ADM and ANP positively correlated with PAH. ANP played a role in the pathophysiologic genesis of PAH.