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目的 研究持续气道正压 (CPAP)治疗对阻塞性睡眠呼吸暂停综合征 (OSAS)患者夜间多尿症状的影响。方法 15例多导睡眠图 (PSG)确诊的OSAS患者 ,记录CPAP治疗前后的夜尿次数、夜尿量、夜尿渗透压和夜尿钠排泄量 ,测定其中 8例患者治疗前后夜间 (2 3时、0 2时、0 5时 )心钠素(ANP)水平。结果 (1)CPAP治疗后OSAS患者夜尿次数明显减少 (P <0 0 1)。 (2 )夜尿量由 (0 0 78± 0 0 17)L/h降至 (0 0 5 2± 0 0 11)L/h(P <0 0 1)。 (3)CPAP治疗后OSAS患者夜尿渗透压由 (381±96 )mmol/L明显增高至 (5 70± 16 9)mmol/L(P <0 0 5 )。 (4 )CPAP治疗后OSAS患者夜尿钠的排泄量由 (1 16± 0 35 )mmol/h降至 (0 6 3± 0 13)mmol/h(P <0 0 1)。 (5 ) 8例患者CPAP治疗前后的夜间ANP平均水平分别为 (146± 14)ng/L和 (10 6± 10 )ng/L ,两者相比差异有显著性 (P <0 0 1)。 (6 ) 8例测定ANP患者在CPAP治疗后ANP降低值与该患者夜尿量降低值、夜尿渗透压增高值、夜尿钠排泄量减少值均有显著的正相关 ,相关系数分别为 0 82、0 84、0 81(P均 <0 0 1)。结论 CPAP治疗可明显减少OSAS患者夜尿次数和夜尿量 ,减少夜尿钠排泄量 ,增加夜尿渗透压 ,这些改变可能与ANP水平降低有关
Objective To investigate the effect of continuous positive airway pressure (CPAP) on nocturnal polyuria in obstructive sleep apnea syndrome (OSAS) patients. Methods Fifteen OSAS patients diagnosed by polysomnography (PSG) were enrolled in this study. The nocturnal urinary counts, nocturia, nocturnal urine osmolality and nocturnal urinary sodium excretion were recorded before and after CPAP treatment. Eight patients were measured before and after treatment at night (23 When 0 2 hours, 0 5:00) atrial natriuretic peptide (ANP) levels. Results (1) The frequency of nocturnal urination in OSAS patients decreased significantly after CPAP treatment (P <0.01). (2) The volume of nocturnal urine decreased from (0 0 78 ± 0 0 17) L / h to (0 0 52 ± 0 0 11) L / h (P 0 01). (3) The osmotic pressure of night urine in patients with OSAS after CPAP treatment was significantly increased from (381 ± 96) mmol / L to (57 ± 16 9) mmol / L (P <0 05). (4) The night natrium excretion of OSAS patients decreased from (116 ± 0 35) mmol / h to (0 6 3 ± 0 13) mmol / h after CPAP treatment (P <0.01). (5) The average nighttime ANP levels in the 8 patients before and after CPAP were (146 ± 14) ng / L and (106 ± 10) ng / L, respectively. There was significant difference between the two groups (P <0.01) . (6) There was a significant positive correlation between the ANP reduction and the nocturnal sodium excretion decrease in 8 cases of ANP patients after CPAP treatment, the correlation coefficients were 0 82,0 84,081 (P <0 0 1). Conclusion CPAP treatment can significantly reduce the number of nocturnal urination and nocturnal urine output in patients with OSAS, reduce nocturnal urinary sodium excretion and increase nocturnal urine osmolality, which may be related to the decrease of ANP level