阻塞性睡眠呼吸暂停低通气综合征对血压及心律失常的影响

目的观察阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep Apnea-hypopnea Syndrome,OSAHS)对血压及心律失常的影响。方法 117例OSAHS患者按照按其睡眠呼吸暂停低通气指数(AHI)及经皮血氧饱和度(SPO2)的变化情况分为轻度、中度、重度组,随机选取35例无OSAHS患者作为对照组。所有入选对象均行多导睡眠图(Polysomnogram,PSG)检查,监测睡前及醒后血压,同时行动态心电图监测。结果睡前及醒后血压水平在OSAHS患者中明显高于对照组(P0.01),并且各组间相比差异均有统计学意义(P0.05)。睡前及醒后血压相比:对照组无显著差异(P0.05),轻度OSAHS组收缩压无显著差异(P0.05),舒张压有显著差异(P0.05),中度及重度OSAHS组收缩压及舒张压水平均有显著差异(P0.05)。中重度OSAHS组心律失常发生率明显高于对照组和轻度OSAHS组,差异有统计学意义(P0.05)。结论 OSAHS本身可以引起夜间血压的升高,且血压的变化随着OSAHS程度的加重而加大。OSAHS在睡眠时有较大的心率变异性,夜间可见明显的高频峰,心率变异夜间大于白天。

Effects of obstructive sleep apnea-hypopnea syndrome on blood pressure and arrhythmia

Objective To observe the effects of obstructive sleep apnea-hypopnea syndrome （OSAHS） on blood pressure and arrhythmia. Methods A total of OSAHS patients were divided into mild group, moderate group, and severe group according to the apnea-hypopnea index and transcutaneous oxygen saturation; 35 patients without OSAHS were randomly selected as control group. All subjects underwent polysomnography, monitoring of blood pressure before and after sleep, and ambulatory electrocardiography. Results OSAHS patients had significantly higher blood pressure before and after sleep than controls （P〈0.01）, and there were significant differences between groups （P〈0.05）. When comparing the blood pressure before sleep with that after sleep, the control group showed no significant differences （P〉0.05）, the mild OSAHS group showed no significant difference in systolic pressure （P〉0.05） but significant difference in diastolic pressure （P〈0.05）, and the moderate and severe OSAHS groups showed significant differences in systolic pressure and diastolic pressure （P〈0.05）. The moderate and severe OSAHS groups had a significantly higher incidence of arrhythmia than the control group and mild OSAHS group （P〈0.05）. Conclusion OSAHS causes an increase in nocturnal blood pressure, and the variation in blood pressure increases as the severity of OSAHS rises. OSAHS patients have a high heart rate variability during sleep, with obvious high-frequency peaks at night, and the heart rate variability is higher at night than in the daytime.