摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及其相关性高血压病患者血浆和肽素(copeptin)水平的变化及其临床意义。方法收集OSAHS患者56例,分为单纯OSAHS组(OSAHS组)29例和OSAHS相关性高血压病组(OSAHS+HT组)27例。另收集同期非OSAHS患者(对照组)30例。分析各组睡眠呼吸紊乱参数、睡前和次日晨起平均动脉压以及血浆copeptin水平,并行多元逐步线性回归分析。结果3组的呼吸暂停低通气指数(AHI)、氧减指数(ODI)、夜间血氧饱和度低于90%时间指数(Ts90%)、最长呼吸暂停时间(LAT)、平均血氧饱和度(MSaO2)和最低血氧饱和度(LSaO2)差别均具有统计学意义(P<0.001);对照组、OSAHS组、OSAHS+HT组的copeptin水平逐渐升高,两两比较,任意两组间的差别均有统计学意义(P<0.05);3组的睡前平均动脉压(MAPn)和次日晨起平均动脉压(MAPd)差别均有统计学意义(P均<0.001)。相关性分析显示,OSAHS组和OSAHS+HT组的copeptin分别与AHI相关性最强(r=0.608,0.802),与MAPn及MAPd正相关(P均<0.05);多元线性回归分析显示,血浆copeptin的影响因素依次为AHI,MAPn及ODI(P均<0.05)。结论OSAHS及其相关性高血压病患者存在精氨酸加压素系统功能异常,copeptin可能参与了OSAHS并发高血压病的发生发展过程。
Objective To investigate the changes and clinical significance of plasma copeptin in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and OSAHS associated hypertension.Methods 56 OSAHS patients who underwent standard polysomnography were enrolled and divided into two groups:29 patients with OSAHS without hypertension(OSAHS group)and 27 patients with OSAHS associated hypertension(OSAHS+HT group).30 individuals who had no OSAHS and hypertension patients were included as control cases(N group).The differences in plasma copeptin,polysomnographic characteristics,mean arterial pressure before sleep(MAPn)and after wakening(MAPd)were compared between groups.Multiple linear regression analysis was used to explore the factors of copeptin.Results The differences in AHI,ODI,Ts90%,LAT,MSaO2,and LSaO2 were statistically significant among the three groups(all P<0.001).The differences in plasma copeptin concentrations among control group,OSAHS group,and OSAHS+HT group were significant.There were significant differences between any two groups(P<0.001).The significant differences in MAPn and MAPd were observed among three groups(P<0.001).In the polysomnographic characteristics,the correlation between copeptin and AHI was the strongest(r=0.608,0.802)in OSAHS group and OSAHS+HT group.Copeptin were correlated positively with MAPn and MAPd in OSAHS group and OSAHS+HT group as well(all P<0.05).Multiple linear regression analysis demonstrated that the major factors affecting plasma copeptin were AHI,MAPn and ODI,successively(all P<0.05).Conclusion The disturbance of the function of arginine vasopressin system is common in patients with OSAHS and OSAHS associated hypertension.Copeptin seems to be involved in the occurrence and development of OSAHS associated hypertension.
作者
滕忠强
林其昌
TENG Zhongqiang;LIN Qichang(Department of Respiratory Medicine, Fujian Province Governmental Hospital, The Affiliated Hospital of Fujian Health College, Fuzhou 350003, China;Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fujian Provincial Diagnosis and Treatment Center for Sleep and Respiratory Disorders, Laboratory of Respiratory Disease of Fujian Medical University, Fuzhou 350005, China)
出处
《福建医科大学学报》
2019年第6期386-390,共5页
Journal of Fujian Medical University
