常规检查血压正常的阻塞性睡眠呼吸暂停低通气综合征患者50例临床分析

目的了解白天常规检查血压正常的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者夜间睡眠中血压的情况。方法选择50例白天常规检查血压正常且经多导睡眠图监测确诊为OSAHS的患者。将50例OSAHS患者按照有无夜间高血压分为有夜间高血压的OSAHS患者组与无夜间高血压的OSAHS患者组，并将2组睡眠监测指标进行比较。多导睡眠图监测同时均行动脉血压监测。睡眠监测后测清晨醒来时血压及抽取空腹静脉血，检测血清内皮素（ET）和降钙素基因相关肽（CGRP）水平。结果夜间睡眠中出现血压升高18例（36％），其中16例清晨醒来时也有血压升高。夜间血压升高的OSAHS患者呼吸紊乱指数、最低血氧饱和度、血清ET、ET／CGRP比值分别为（39．07±6．12）次／h、（69．11±8．89）％、（1．24±0．17）g／L、（2．49±0．62），与无夜间高血压组（27．11±5．07）次／h、（83．39±10．04）％、（0．87±0．14）g／L、（1．91±0．46）]相比均明显升高。结论以白天常规血压检查来衡量OSAHS患者是否合并高血压会使一部分有夜间高血压的患者漏诊。

Clinical analysis of 50 obstructive sleep apnea-hypopnea syndrome patients with normal day-time blood pressure

Objective To observe the night blood pressure in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with normal day-time blood pressure. Methods According to level of night blood pressure, 50 OSAHS patients were divided into two groups: patients with hypertension in sleeping and patients without hyperten-sion in sleeping. Polysomnogram and arterial pressure were tested. Serum endothelin (ET) and calcitonin gene-re-lated peptide (CGRP) levels were measured and compared. Results Eighteen OSAHS patients had hypertension in sleeping. Among them 16 patients had hypertension at morning. The apnea hypopnea index (AHI),the lowest SaO2、the serum levels of ET and ET/CGRP ratio in the OSAHS patients with hypertension in sleeping were higher than those in OSAHS patients without hypertension in sleeping. Conclusion A part of OSAHS patients with hyper-tension in sleeping might be unnoticed only by day-time blood pressure.