高血压伴夜间低氧血症对血压节律的影响

目的:观察高血压合并睡眠呼吸暂停综合征患者血压的变化节律。方法:选择夜间打鼾、体重指数≥25的高血压患者95例,监测夜间7 h的血氧饱和度和24 h动态血压。根据夜间氧饱和度情况分为高血压合并低氧血症组和单纯高血压组,所有患者均经病史、体检、实验室检查排除继发性高血压、心力衰竭、脑血管病、肾功能衰竭、哮喘。结果:高血压合并低氧血症组24 b平均收缩压、24 h平均心率、白昼平均收缩压、白昼平均心率、夜间平均收缩压、夜间平均心率与单纯高血压组相比有显著差异(P<0.05);高血压合并轻、中度低氧血症组中75.3%患者动态血压昼夜节律消失,单纯高血压组血压昼夜节律消失占7.1% 杓型组与非杓型组患者夜间平均收缩压及夜间平均舒张压有显著差异(P<0.05)。结论:高血压合并夜间低氧血症患者血压水平及心率较单纯高血压组明显增高,随着低氧血症的加重,增高趋势明显;高血压合并低氧血症组多数血压昼夜节律消失,非杓型组夜间血压较杓型组增高显著。

Blood Pressure Day-nocturnal Rhythm in Hypertension Patients with Nightly Hypoxemia

Objective:To study the blood pressure day-nocturnal rhythm in hypertension patients with obstructive sleep apnea syndrome(OSAS). Methods: The saturation of oxygen (SaO2)for 7 hours during sleep and the ambulatory blood pressure were measured in 95 hypertension patients with nightly snoring whose body mass index was more than 25 kg m2. We classified the patients as hypertension with nightly hypoxemia group and single hypertension group according to the of SaO2 Secondary hypertension.heart failure.cerebrovascular diseases, renal failure as well as asthma were excluded in all patients. Results: The difference of 24-hour mean systolic blood pressure.24-hour mean heart rate.diurnal mean systolic blood pressure.drurnal mean heart rate, nocturnal mean systolic blood pressure ( nSBP). diurnal mean heart rate, casual systolic blood prcssure . casual diastolie blood pressure between hypertension with hypoxemia group and single hypertension group was statistic-ally significant (P<0.05). The blood pressure day-nocturnal rhythm of 75. 3% patients disappeared in hypertension with mild and moderate hypoxemia groups; While only that of 7. 1 % patients disappeared in single hypertension group. The difference of nSBP and nocturnal mean diastolic blood pressure (nDBP )between dipper group and non-dipper group were statistically significant (P 0.05). Conclusion:The blood pressure and heart rate in hypertension with hypoxemia group increased obviously than that of normal group and the increase was correlated to the severity of hypoxemia. The blood pressure day-nocturnal rhythm of most patients disappeared in hypertension with hypoxemia group. The nocturnal blood pressure of non-dipper group increase obviously than that of dipper group.