尿中電解質変動測定の臨床応用 睡眠時無呼吸,食塩感受性高血圧の早期診断の可能性

尿电解质波动测量的临床应用 早期诊断睡眠呼吸暂停和盐敏感性高血压的可能性

• 批准号: 23931027
• 负责人: 田中 雅美
• 金额: $ 0.19万
• 依托单位: The University of Tokyo
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Scientists
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-23931027/
• 关键词: 睡眠時無呼吸症候群; 尿電解質

「研究目的」睡眠時無呼吸症候群(以下SAS)に伴う食塩感受性高血圧の早期診断と予防医学に対する臨床検査の役割の可能性を検討する.早朝尿と起床後の尿中ナトリウム,尿中クロールおよび尿中有機酸の変化を測定することにより睡眠時と覚醒時の体液バランスの変化を評価する.また,睡眠時無呼吸症候群では睡眠中に呼吸性アシドーシスになること本研究をもとに簡便に診断できることを検証する.「研究方法」睡眠時無呼吸症候群疑いの患者98名(BMI:18.2-39.6,AHI:0-59回/h,SpO_295%以上:42.6-100%),簡易携帯型の呼吸不全モニターを装着し,睡眠中の無呼吸数(AHI 回/h),酸素飽和度(%)を測定した.また,翌朝の第一尿と第二尿を採取し,尿化学定量(尿電解質・尿蛋白・尿微量アルブミン・尿クレアチニンなど),尿定性検査(pH・比重・蛋白・糖・ケトン体)を測定し,第一尿と第二尿の比較検討を行った.特に,AHI 10回/h以下をSAS陰性群(n=41),AHI 20回/h以上をSAS陽性群(n=33)として,尿のアニオンバランスの評価を行った.「研究成果」第一尿,第二尿各々の(Na-Cl)を比較検討した結果,y=0.484x-19.4,r=0.421(x:第一尿,y:第二尿)と相関が認められ,第一尿はNaよりClの方が高値傾向,第二尿はNaの方が高値傾向であった.しかし,SAS陰性群,SAS陽性群に分け比較した結果,SAS陽性群は陰性群に比べ,Clが高値傾向であったが,両群は有意な差(p>0.05)が認められなかった.SAS陰性群,SAS陽性群での,第一尿,第二尿のpHを比較したが,両群ともにpH5.2-pH7.4であり,有意な差(p>0.05)は認められなかった.本研究では,SAS陰性群,SAS陽性群で尿のアニオンバランスの評価を行った.第一尿はClが高値傾向,第二尿はNaが高値傾向であったが,SAS陰性群とSAS陽性群では有意な差(p>0.05)は認められなかった。

Objective To investigate the possibility of early diagnosis and preventive medicine for sleep apnea syndrome (SAS) associated with food-sensitive hypertension. Urine in the morning, urine after waking up, urine and organic acid changes in the urine were measured, and body fluid changes during sleep and waking were evaluated. This study aims to simplify the diagnosis and diagnosis of sleep apnea syndrome. 98 patients (BMI: 18.2 - 39.6, AHI: 0 - 59 cycles/h, SpO_2> 95%: 42.6 - 100%) with sleep apnea syndrome were investigated. The first and second urine samples of the next day were collected, urine chemistry quantitative (urine electrolytes, urine protein, urine trace), urine qualitative test (pH, specific gravity, protein, sugar, body) were determined, and the first and second urine samples were compared. In particular, SAS negative group (n = 41) with AHI less than 10 cycles/h, SAS positive group (n = 33) with AHI more than 20 cycles/h, and SAS negative group (n = 31) with AHI less than 10 cycles/h. The results of comparative study of the first urine and the second urine showed that y = 0.484x-19.4, r = 0.421 (x: the first urine, y: the second urine) and correlation coefficient, the first urine had a high Na Cl ratio, and the second urine had a high Na Cl ratio. When comparing the SAS negative group and the SAS positive group, the results showed that the SAS positive group had a higher Cl value than the negative group, and the negative group had an intentional difference (p> 0.05). In the SAS negative group and the SAS positive group, the pH of the first urine and the second urine were compared, and the pH of the first urine and the second urine were compared, and the pH of the second urine was 5.2 - 7.4, and the intentional difference (p> 0.05) was recognized. In this study, SAS negative group and SAS positive group were evaluated. The first urine has a high Cl value tendency, the second urine has a high Na value tendency, SAS negative group and SAS positive group have an intentional difference (p> 0.05).