高血压合并阻塞性睡眠呼吸暂停综合征的动态血压及血压节律观察

【目的】观察高血压合并阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）患者动态血压（ambulatorv blood pressure，ABP）及血压节律的变化。【方法】经门诊测量血压（clinical blood pressure，CBP），并行多导睡眠仪（polrsomnography）及动态血压监测符合标准的60例研究对象入选本研究。动态血压监测并记录白天、夜间收缩压（systolic blood pressure，SBP）及舒张压（diastolic blood pressure，DBP）。根据监测结果分为：正常对照组、高血压病（essential hypertention，EH）组、EH合并OSAS组、单纯OSAS组。【结果】与正常对照组相比，EH组及EH合并OSAS组白天SBP（dSBP）、白天DBP（dDBP）、夜间SBP（nSBP）、夜间DBP（nDBP）明显升高；EH合并OSAS组dSBP和nSBP以及nDBP较EH组患者升高，有统计学差异。与EH组相比，OSAS组及EH合并OSAS组血压昼夜节律消失比例明显升高，有统计学差异。【结论】EH合并OSAS组患者血压变异性显著高于单纯高血压病患者，OSAS可独立引起血压昼夜节律的改变。

Observation on the circadian rhythm and 24 h ambulatory blood pressure in hypertensive patients complicated with obstructive sleep apnea syndrome

Objective] To study the circadian rhythm and 24 h ambulatory blood pressure （ABP） in hypertensive patients complicdted with obstructive sleep apnea syndrome （OSAS）. Methods] Sixty OSAS patients and 15 normal volunteers were measured by polysomnography （PSG） during sleep and ABP were monitored for a period of 24 hours. Results] In hypertensive group and hypertensive with obstructive sleep apnea syndrome （OSAS） group, dSBP, dDBP, nDBP and nSBP were significantly higher than those in control group. In hypertensive with OSAS group, dSBP, nSBP and nDBP were significantly higher than those in hypertensive group. There was significant difference of circadian rhythm of blood pressure in the OSAS group and hypertensive with OSAS group as compared with hypertensive group （all P 〈 0.05）. Conclusions] These findings suggest that obstructive sleep apnea syndrome may cause the change of circadian rhythm of blood pressure independently.