Jankowska R, Brzecka A, Passowicz-Muszyńska E
Katedry i Kliniki Chorób Płuc A M we Wrocławíu.
Pneumonol Alergol Pol. 2001;69(11-12):644-9.
During obstructive sleep apneas stimuli, that may increase excretion of atrial natriuretic peptide (ANP) occur. The aim of the study was the evaluation whether in patients with OSAS levels of ANP are significantly different in relation to sleep or wakefulness and in relation to disturbances of ventilation during sleep and wakefulness. The material of the study consisted of 34 patients with OSAS (age 25-65 years). There were no differences in the levels of ANP late in the evening, during sleep and early in the morning. There were 2 groups of the patients: with low (< 70 pg/ml, mean at 21 p.m. 9.7 +/- 8.7 pg/ml, at. 2 a.m. 12.5 +/- 9.3 pg/ml, at 6 a.m. 14.4 +/- 15.1 pg/ml) and high (> 70 pg/ml, mean at 21 p.m. 148.6 +/- 232.9 pg/ml, at 2 a.m. 119.5 +/- 45.5 pg/ml, at 6 a.m. 164.9 +/- 161 pg/ml) ANP levels. As compared with patients with low ANP levels, patients with high ANP levels were older and more obese, more frequently had concomitant COPD, lower VC and FEV1, higher daytime PaCO2 and lower PaO2; most of them had peripheral edema. In patients with high ANP levels there was more profound mean arterial blood desaturation during sleep apnoeas than in patients with low ANP levels (SaO2 75 +/- 8% vs 81 +/- 4%, p < 0.001), although apnea index and mean apnea duration were similar in both groups.
In patients with OSAS the daytime and sleep levels of ANP are similar. High levels of ANP can be found in OSAS patients with impaired daytime ventilation and gas exchange, and profound arterial oxygen desaturation during sleep apnoeas.
在阻塞性睡眠呼吸暂停刺激期间，可能会出现增加心房利钠肽（ANP）排泄的情况。本研究的目的是评估阻塞性睡眠呼吸暂停低通气综合征（OSAS）患者的ANP水平在睡眠或清醒状态下以及在睡眠和清醒时通气障碍方面是否存在显著差异。研究材料包括34例OSAS患者（年龄25 - 65岁）。晚上晚些时候、睡眠期间和清晨的ANP水平没有差异。患者分为两组：ANP水平低（<70 pg/ml，晚上9点时平均为9.7±8.7 pg/ml，凌晨2点时为12.5±9.3 pg/ml，早上6点时为14.4±15.1 pg/ml）和高（>70 pg/ml，晚上9点时平均为148.6±232.9 pg/ml，凌晨2点时为119.5±45.5 pg/ml，早上6点时为164.9±161 pg/ml）。与ANP水平低的患者相比，ANP水平高的患者年龄更大、更肥胖，更常伴有慢性阻塞性肺疾病（COPD），肺活量（VC）和第一秒用力呼气容积（FEV1）更低，白天动脉血二氧化碳分压（PaCO2）更高，动脉血氧分压（PaO2）更低；他们中的大多数有外周水肿。与ANP水平低的患者相比，ANP水平高的患者在睡眠呼吸暂停期间平均动脉血氧饱和度下降更明显（血氧饱和度[SaO2]为75±8%对81±4%，p<0.001），尽管两组的呼吸暂停指数和平均呼吸暂停持续时间相似。
在阻塞性睡眠呼吸暂停低通气综合征患者中，白天和睡眠时的ANP水平相似。在白天通气和气体交换受损以及睡眠呼吸暂停期间动脉血氧饱和度明显下降的阻塞性睡眠呼吸暂停低通气综合征患者中可发现高水平的ANP。
