Cahan C, Decker M J, Arnold J L, Goldwasser E, Strohl K P
Department of Medicine, Case Western Reserve University, Cleveland, Ohio 44106, USA.
J Appl Physiol (1985). 1995 Oct;79(4):1278-85. doi: 10.1152/jappl.1995.79.4.1278.
The effect of nasal continuous positive pressure (CPAP) treatment on erythropoietin (EPO) was examined by measuring diurnal serum EPO levels before and twice (over the 3rd day and over 1 day on recall after > or = 1 mo of therapy) after initiation of treatment in 12 obstructive sleep apnea syndrome patients with normal hemoglobin, hematocrit, creatinine, blood urea nitrogen, and albumin levels. Over each study day, oxygen saturation was measured by an ambulatory pulse oximetry system. Patients spent 27 +/- 9% (SE) of time below oxygen saturation of 88% vs. 2.1 +/- 0.6% after initiation of nasal CPAP treatment (P < 0.01). The number of desaturation events per hour of sleep before nasal CPAP treatment was 62 +/- 6 vs. 9 +/- 2 with nasal CPAP (P < 0.01). EPO levels measured by radioimmunoassay were drawn every hour before and at 3 days (n = 9) and before and at recall (n = 0) after initiation of CPAP therapy. The mean serum EPO level was higher before treatment (61 +/- 14 mU/ml) than that at 3 days (38 +/- 10 mU/ml, P < 0.01) or at recall (32 +/- 7 mU/ml, P < 0.01). We conclude that nasal CPAP treatment of sleep-disordered breathing will reduce diurnal levels of EPO.
通过测量12例血红蛋白、血细胞比容、肌酐、血尿素氮和白蛋白水平正常的阻塞性睡眠呼吸暂停综合征患者治疗前及治疗开始后两次（治疗3天后以及治疗≥1个月后召回随访1天时）的日间血清促红细胞生成素（EPO）水平，研究鼻持续气道正压通气（CPAP）治疗对EPO的影响。在每个研究日，通过动态脉搏血氧饱和度测定系统测量血氧饱和度。患者在治疗前有27±9%（标准误）的时间血氧饱和度低于88%，而在开始鼻CPAP治疗后这一比例为2.1±0.6%（P<0.01）。鼻CPAP治疗前每小时睡眠中的血氧饱和度下降事件数为62±6次，治疗后为9±2次（P<0.01）。在CPAP治疗开始前及治疗3天（n=9）时以及召回随访（n=0）时，每小时采集血样，采用放射免疫分析法测定EPO水平。治疗前血清EPO平均水平（61±14 mU/ml）高于治疗3天时（38±10 mU/ml，P<0.01）或召回随访时（32±7 mU/ml，P<0.01）。我们得出结论，鼻CPAP治疗睡眠呼吸障碍可降低EPO的日间水平。
