Objective  To investigate the changes and clinical relationship of plasma adrenomedullin( ADM) , atrial natriuretic polypeptide( ANP) , and heart rate variability( HRV) in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods  Seventy-five inpatients with OSAHS were enrolled in this study. According to the apnea hypopnea index ( AHI) by polysomnography, the subjects were divided into a mild group, a moderate group, and a severe group. Meanwhile, HRV was screened by
dynamic electrocardiogram in sleep laboratory. HRV parameters were obtained including LF ( low frequency power) , HF( high frequency power) , pNN50( percentage of NN50 in the total number of N-N intervals) ,SDNN( standard deviation of the N-N intervals) , rMSSD( square root of the mean squared differences of successive N-N intervals ) . Plasma levels of ADM/ANP were measured by radioimmunoassay. Results  The levels of SDNN ( P  lt;0. 05) , rMSSD, pNN50, LF ( P  lt; 0. 05) and HF were gradually reduced, and the levels of ADM ( P  lt;0. 05) and ANP ( P  lt; 0. 05) were increased with increasing severity of OSAHS. Linear correlation analysis demonstrated that SDNN was negatively correlated with ADM( r = - 0. 423, P  lt;0. 05)and ANP( r = - 0. 452, P  lt; 0. 05) , and LF was also negatively correlated with ADM( r = - 0. 348, P  lt;
0. 05) . Conclusion  Lower HRV is associated with more sever OSAHS, and it may be modulated neurohumorally by ADM and ANP.

Citation： WANG Peifang,HU Zheng,XIA Guohui. Changes and Significancy of Adrenomedullin, Atrial Natriuretic Polypeptide and Heart Rate Variability in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(6): 569-571. doi: Copy