老年睡眠呼吸障碍与动态血压变化观察

目的:探讨老年睡眠呼吸障碍(SAS)患者24h动态血压变化特点及可能的发病机制。方法:对2005—2006年在我科住院诊治的患者进行问卷调查,患者配戴手握式脉搏血氧仪及24h动态血压监测,选择老年SAS合并高血压患者组30例、单纯SAS患者血压正常组30例、无SAS的高血压患者组20例为研究对象。结果:3组患者呼吸紊乱指数、最低血氧饱和度、氧减指数等指标差异有统计学意义(均P<0.05);平均收缩压、平均舒张压3组患者比较差异有统计学意义(均P<0.05);睡前、晨起收缩压、舒张压3组比较差异有统计学意义(均P<0.05);SAS合并高血压组晨起血压较睡前血压明显增高(均P<0.05)。结论:睡眠呼吸紊乱和低氧血症是引起SAS患者高血压形成的重要因素,SAS合并高血压患者血压整体水平较高,晨起舒张压升高尤为明显。

The Relation between Obstructive Sleep Apnea Syndrome and Hypertension in Elderly

Objective: To study the relationship between obstructive sleep apnea syndrome (SAS) and hypertension in elderly patients. Methods: Thirty patients with SAS and hypertension and 30 cases with SAS confirmed by polysomnography (PSG) were monitored ambulatory blood pressure in 24 hours. Twenty hypertensive patients without SAS were used as control. Result: There were significant differences in apnea hyponea index and percent of time in saturation lower than 70% in the cases with SAS and hypertension group compared with that of only SAS group(P < 0.05). There were significant differences in aver-age systolic pressure and diastolic pressure (SBP and DBP) in 24 hours,and before sleeping in the night and just after waking in the morning among three groups(P < 0.05). The blood pressure was significantly higher just after waking in the morning than that before sleeping in the night in patients with SAS and hypertension(P < 0.05). Conclusion: Sleep-related breathing disorders and hypox-emia are important factors which lead to hypertension in patients with SAS. The total levels of blood pressure,especially the dias-tolic pressure of just after waking in the morning,are much higher in patients with SAS and hypertension.