Akashiba T, Otsuka K, Yoshizawa T, Kurashina K, Kawamura T, Sasaki I, Hosokawa Y, Horie T
First Department of Internal Medicine, Nihon University School of Medicine, Tokyo.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 May;29(5):573-7.
Nocturnal renal function was examined in 8 patients with obstructive sleep apnea syndrome (OSAS) and the effects of nasal CPAP (NCPAP) on renal function were also studied. Nocturia was observed more than twice in all cases when no treatment was performed, but it disappeared after initiation of NCPAP. Fractional nocturnal urine volume and creatinine clearance decreased significantly from 1.36 +/- 0.15 ml/min to 0.75 +/- 0.20 ml/min (p less than 0.01) and from 116.8 +/- 46.5 ml/min to 101.1 +/- 33.0 ml/min (p less than 0.05), respectively, after initiation of NCPAP. Although the serum Na and creatinine did not change following NCPAP, the urine Na and creatinine changed significantly after NCPAP therapy. The serum renin, aldosterone, and ADH did not change after NCPAP therapy. The significant positive correlation (p less than 0.05) between the fractional nocturnal urine volume and DI, and also significant inverse correlation (p less than 0.05) between the fractional urine volume and %FRC were observed. These results suggest that the abnormal renal function seen in cases of OSAS is related to the hypoxemia during sleep. It was concluded that the nocturnal renal function in cases of OSAS was different from those in normal controls and NCPAP therapy induced the recovery of these abnormalities.
对8例阻塞性睡眠呼吸暂停综合征(OSAS)患者进行了夜间肾功能检查,并研究了鼻持续气道正压通气(NCPAP)对肾功能的影响。在未进行治疗时,所有病例均观察到夜尿超过两次,但在开始使用NCPAP后夜尿消失。开始使用NCPAP后,夜间尿分流量和肌酐清除率分别从1.36±0.15 ml/min显著降至0.75±0.20 ml/min(p<0.01),从116.8±46.5 ml/min降至101.1±33.0 ml/min(p<0.05)。尽管NCPAP治疗后血清钠和肌酐没有变化,但NCPAP治疗后尿钠和肌酐有显著变化。NCPAP治疗后血清肾素、醛固酮和抗利尿激素没有变化。观察到夜间尿分流量与去氧指数之间存在显著正相关(p<0.05),尿分流量与功能残气量百分比之间存在显著负相关(p<0.05)。这些结果表明,OSAS患者中出现的肾功能异常与睡眠期间的低氧血症有关。得出的结论是,OSAS患者的夜间肾功能与正常对照组不同,NCPAP治疗可使这些异常恢复。