整夜完全睡眠剥夺对某部队军人动态血压的影响

目的探讨急性睡眠剥夺对驻军某部队军人动态血压各项指标的影响及可能的发生机制。方法选择驻军某部队60名健康军人进行横断面研究,采用24 h整夜完全睡眠剥夺方法。在睡眠剥夺过程中应用动态血压记录仪监测血压等各项指标。睡眠剥夺后检测儿茶酚胺(多巴胺、肾上腺素和去甲肾上腺素)、肾素、血管紧张素和醛固酮水平。恢复1周后再次检测血儿茶酚胺水平作为对照。结果睡眠剥夺后:(1)夜间血压负荷增高,夜间收缩压负荷为55.3%±37.0%,夜间舒张压负荷为26.5%±28.8%;(2)血儿茶酚胺水平升高,与恢复期比较差异有统计学意义[多巴胺(8.76±2.63)μg/L比(7.44±2.54)μg/L,肾上腺素(31.91±11.79)μg/L比(25.58±8.51)μg/L,去甲肾上腺素(2.12±1.03)μg/L比(1.27±0.47)μg/L]。肾上腺素水平与平均心率呈正相关(r=0.446,P<0.05)。肾素、血管紧张素和醛固酮水平升高[肾素(3.33±2.00)nmol.L-1.h-1,血管紧张素Ⅱ(67.98±27.46)ng/L,醛固酮(495.58±70.04)pmol/L]。结论急性整夜完全睡眠剥夺可导致健康成年男性夜间血压负荷增高,昼夜节律消失,是高血压发生的危险因素,可能会增加心血管事件的风险。睡眠剥夺后血儿茶酚胺、肾素、血管紧张素和醛固酮水平升高,提示儿茶酚胺与肾素-血管紧张素-醛固酮系统可能共同参与动态血压的调节。

Effects and possible mechanism of sleep deprivation on ambulatory blood pressure of the soldiers

Objective To investigate the changes and possible mechanism of ambulatory blood pressure after acute sleep deprivation of the soldiers. Methods Sixty healthy male soldiers were studied by overnight acute sleep deprivation method.Ambulatory blood pressure was monitored during sleep deprivation.Blood catecholamine(including dopamine,adrenaline and norepinephrine) were measured 24 h and 7d after sleep deprivation.Plasma rennin,angiotensin and aldosterone were also measured 24h after sleep deprivation. Results After sleep deprivation,night blood pressure load was increased.The night systolic blood pressure(SBP) and diastolic blood pressure(DBP) load were 55.3%±37.0% and 26.5%±28.8% respectively.Blood catecholamine were significantly increased after sleep deprivation [dopamine(8.76±2.63) μg/L vs.(7.44±2.54) μg/L,adrenaline(31.91±11.79) μg/L vs.(25.58±8.51) μg/L and norepinephrine(2.12±1.03) μg/L vs.(1.27±0.47) μg/L,all P<0.05].Plasma rennin,angiotensin and aldosterone were also elevated [rennin(3.33±2.00) nmol·L-1·h-1,angiotensin Ⅱ(67.98±27.46) ng/L,aldosterone(495.58±70.04) pmol/L] after sleep deprivation.Adrenaline was positively correlated with mean heart rate(r=0.446,P<0.05). Conclusions Acute sleep deprivation can cause night blood pressure elevation and the circadian rhythm disappear in healthy male soldiers.Blood catecholamine,rennin,angiotensin and aldosterone are increased after sleep deprivation,which suggest that they are participated in the regulation of blood pressure.