在使用鼻持续气道正压通气（nCPAP）治疗阻塞性睡眠呼吸暂停（OSA）期间，夜间利尿和利钠作用的降低与环磷酸鸟苷（cGMP）排泄相关。

Reduction of nocturnal diuresis and natriuresis during treatment of obstructive sleep apnea (OSA) with nasal continuous positive air pressure (nCPAP) correlates to cGMP excretion.

作者信息

Ehlenz K, Firle K, Schneider H, Weber K, Peter J H, Kaffarnik H, von Wichert P

机构信息

Abteilung für Endokrinologie und Stoffwechsel, Universität, Marburg.

出版信息

Med Klin (Munich). 1991 Jun 15;86(6):294-6, 332.

PMID:1653395

Abstract

In ten patients with severe obstructive sleep apnea (OSA) profound changes in renal function could be demonstrated at night during nCPAP therapy. Natriuresis and diuresis decreased by about 50% while creatinine excretion rate and urinary osmolality did not change. We found parallel changes in the excretion of ANP's second messenger cyclic guanosine monophosphate (cGMP) in a dose-response-related manner to natriuresis respectively diuresis. These data are in agreement with recently demonstrated decrease of nocturnal plasma levels of atrial natriuretic peptide (ANP) during nCPAP therapy in apneic patients. This may be an indicator for an increased cardiac volume load during obstructive apnea. The decrease of diuresis, natriuresis and cGMP excretion demonstrate the beneficial effects of nCPAP treatment on the cardiovascular system. Therefore measurements of cGMP excretion may be a useful parameter to assess the cardiovascular function of apneic patients before and during treatment.

摘要

在10例重度阻塞性睡眠呼吸暂停（OSA）患者中，夜间持续气道正压通气（nCPAP）治疗期间可显示出肾功能的显著变化。利钠和利尿减少约50%，而肌酐排泄率和尿渗透压未改变。我们发现，心房钠尿肽（ANP）的第二信使环磷酸鸟苷（cGMP）的排泄分别与利钠和利尿呈剂量反应相关的平行变化。这些数据与最近显示的呼吸暂停患者在nCPAP治疗期间夜间血浆心房钠尿肽（ANP）水平降低一致。这可能是阻塞性呼吸暂停期间心脏容量负荷增加的一个指标。利尿、利钠和cGMP排泄的减少证明了nCPAP治疗对心血管系统的有益作用。因此，测量cGMP排泄可能是评估呼吸暂停患者治疗前后心血管功能的一个有用参数。