睡眠呼吸暂停综合征患者尿尿酸,心钠素,肾素—醛固酮的？…

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（ｎＣＰＡＰ）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。同时研究ＳＡＳ患者的心钠素（ＡＮＰ）、肾素、醛固酮水平的变化及ｎＣＰＡＰ治疗与ＳＡＳ的夜间多尿的关系。方法 选取经多导睡眠图（ＰＳＧ）确诊为ＳＡＳ的患者２２例为试验组，１１名ＰＳＧ检查下沉者为姐，１３例重度ＳＡＳ患者接受ｎＣＰＡ

Significance of thechanges of urinary uric acid, ANP, renin and aldosterone in sleep apnea syndrome patients

OBJECTIVES: 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). Another purpose is to explore the relationship between the nocturnal diuresis and atrial natriuretic peptide (ANP), renin-aldosterone in SAS. METHODS: 22 cases diagnosed as SAS by polysomnography (PSG) were selected as trial group, 11 cases excluded from SAS by PSG were as control group, and 13 severe SAS patients were treated by nCPAP and taken as nCPAP therapy group. The markers mentioned above were compared in these groups. RESULTS: The overnight change in urinary uric acid/creatinine ratio in trial group is 0.47 +/- 0.31, which is significantly higher than that in control group (0.01 +/- 0.23), P < 0.05, and in nCPAP therapy group after therapy (0.01 +/- 0.19) significantly lower than that before nCPAP therapy (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 that in control group (3.2 +/- 1.4) mg/L, P < 0.001, and in nCPAP therapy group (3.3 +/- 1.2) mg/L significantly lower than that before nCPAP (5.9 +/- 2.6) mg/L, P < 0.05. The mean morning blood ANP in trial group is (0.182 +/- 0.004) microgram/L, which is higher than that in control group (0.182 +/- 0.004) microgram/L, P < 0.05, and in nCPAP therapy group (0.122 +/- 0.001) microgram/L is much lower than that before nCPAP therapy (0.180 +/- 0.003) microgram/L, P < 0.001. However there are no statistic significant differences between these groups in blood renin-aldosterone. CONCLUSIONS: The urinary uric acid excretion and overnight change in urinary uric acid/creatinine are good markers to determine the effects of nCPAP on SAS. The nocturnal diuresis in SAS patients is correlated with the increase of ANP in plasma.