Hübner Ralf-Harto, El Mokhtari Nour Eddine, Freitag Sandra, Rausche Tim, Göder Robert, Tiroke Andreas, Lins Markus, Simon Rüdiger, Bewig Burkhard
Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstrasse 12, 24105 Kiel, Germany.
Respir Med. 2008 Jan;102(1):134-42. doi: 10.1016/j.rmed.2007.07.023. Epub 2007 Sep 24.
N-terminal pro-brain natriuretic peptide (NT-ProBNP) has emerged as an important marker of cardiac stress and may reflect the severity of underlying cardiac dysfunction, which is thought to be associated with obstructive sleep apnoea syndrome (OSAS).
This study evaluated the plasma concentration of NT-ProBNP in 60 consecutive patients (median age 55.7 years, median body mass index (BMI) 31.8) who were referred to a sleep laboratory with a suspicion of OSAS. Each subject underwent measurement of morning NT-ProBNP plasma levels, polysomnography and echocardiography. Patients were treated with nasal continuous or bilevel positive airway pressure ventilation (nCPAP/BIPAP) or without mechanical respiratory support, depending on clinical symptoms and results of polysomnography. Three months after treatment of OSAS 28 of the patients were reassessed for re-evaluation of NT-ProBNP and polysomnography.
Low or high levels of NT-proBNP were not associated with AHI and other sleep related indices (p>0.3). There was no correlation between NT-proBNP and AHI or other sleep related indices. In multiple regression analysis, NT-proBNP was significantly correlated with left ventricular ejection fraction, creatinine clearance and the presence of systemic arterial hypertension but not with AHI.
Our results show by a robust multiple regression analysis, that NT-pro BNP is not associated with OSAS and NT-pro BNP cannot be used as a sensitive marker for underlying cardiovascular abnormalities in patients with OSAS.
N端前脑钠肽（NT-ProBNP）已成为心脏应激的重要标志物，可能反映潜在心脏功能障碍的严重程度，而这种功能障碍被认为与阻塞性睡眠呼吸暂停综合征（OSAS）有关。
本研究评估了60例连续转诊至睡眠实验室、疑似患有OSAS的患者（中位年龄55.7岁，中位体重指数（BMI）31.8）的血浆NT-ProBNP浓度。每位受试者均接受清晨NT-ProBNP血浆水平测定、多导睡眠图检查和超声心动图检查。根据临床症状和多导睡眠图检查结果，患者接受鼻持续气道正压通气或双水平气道正压通气（nCPAP/BIPAP）治疗，或不接受机械通气支持。OSAS治疗三个月后，对28例患者进行重新评估，以再次评估NT-ProBNP和多导睡眠图。
NT-proBNP水平的高低与呼吸暂停低通气指数（AHI）及其他睡眠相关指标无关（p>0.3）。NT-proBNP与AHI或其他睡眠相关指标之间无相关性。在多元回归分析中，NT-proBNP与左心室射血分数、肌酐清除率及系统性动脉高血压的存在显著相关，但与AHI无关。
我们的结果通过强有力的多元回归分析表明，NT-pro BNP与OSAS无关，且NT-pro BNP不能用作OSAS患者潜在心血管异常的敏感标志物。
