阻塞性睡眠呼吸暂停低通气综合征与高血压的相关性及影响因素分析

目的 通过分析阻塞性睡眠呼吸暂停低通气综合征（OSAHS）各参数与高血压的相关性,探讨OSAHS导致并发高血压的危险因素.方法 将244例OSAHS患者分为4组：单纯OSAHS组、轻度OSAHS合并高血压组、中度OSAHS合并高血压组、重度OSAHS合并高血压组.比较4组患者的一般临床资料、多导睡眠监测（PSG）参数、睡前及醒后收缩压及舒张压,Logistic回归分析各因素与高血压发病的相关性.结果 （1）在合并高血压的3组患者中,随着OSAHS的加重,患者BMI、氧减指数（ODI）、90％以下氧减饱和度指数（Ts90％）、微觉醒指数（AI）逐渐增加（P＜0.05）,最低氧饱和度（LSaO2）、非快速动眼睡眠3期时间占总睡眠时间百分比（N3％）逐渐降低（P＜0.05）;（2）4组患者醒后舒张压显著高于睡前,重度OSAHS合并高血压患者醒后收缩压和舒张压显著高于轻度和中度OSAHS合并高血压者（P＜0.05）;中度OSAHS合并高血压组醒后收缩压及舒张压均显著高于轻度OSAHS合并高血压组（P＜0.05）.（3）Logistic回归分析显示,OSAHS患者各指标与高血压相关性依次为Ts90％、LSaO2、ODI、睡眠呼吸暂停低通气指数（AHI）、BMI、AI（P＜0.05）.结论 随着OSAHS的加重,合并高血压的患者醒后收缩压及舒张压升高越明显.Ts90％、ODI、LSaO2、AHI、BMI、AI是高血压的独立危险因素,在高血压的发病中可能起着重要作用.

Clinical analysis of the relationship of obstructive sleep apnea-hypopnea syndrome and hypertension

Objective To study the relationship between obstructive sleep apnea hypopnea syndrome（OSAHS） and hypertension in order to confirm the independent risk factors for hypertension. Methods 244 OSAHS patients was investigated. The whole cases were subgrouped into the following four groups ： the patients with OSAHS, the patients with mild OSAHS and hypertension, the patients with moderate OSAHS and hypertension, the patients with severe OSAHS and hypertension. Then the general clinical data and the mean blood pressure before sleep and after wakening were compared among these four groups. Logistic multiple regression analysis was conducted to assess what was the independent factors for hypertension. Results （1）There were significant differences among mild, moderate and severe OSAHS with hypertension patients in factors like BMI, ODI, Ts90%, AI, LSaO2, ESS, N3%. （2） The diastolic blood pressure after wakening were higher than that before sleep in four groups. Severe OSAHS with hypertension patients had significantly higher diastolic pressure and systolic pressure after wakening than those of mild and moderate OSAHS with hypertension patients. （3）Multivariate logistic regression analysis showed that Ts90%, ODI, ESaO2, AHI and AI were significantly correlated with hypertension. Conclusion Our results suggested that Ts90%, ODI, LSaO2, AHI, AI are independent risk factors for hypertension, OSAHS may play an important role in hypertension pathogenesis.