阻塞性睡眠呼吸暂停低通气综合征与高血压的临床研究

目的　通过测定阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者血压以探讨其高血压的发病状况及与病情轻重的关系。方法　随机抽取 30例正常人 ,111例OSAHS患者进行整晚多导睡眠图检查 ,次晨醒后马上测量血压 ;随机抽取 2 0例中、重度OSAHS患者使用持续气道内正压通气 (CPAP)呼吸机治疗 1个月 ,治疗过程中每天早上醒时马上测定血压以了解血压变化情况。此外以平均血压为因变量 ,年龄、体重指数 (BMI)、呼吸暂停低通气指数(AHI)、最低血氧饱和度 (SaO2 min)、腹围和颈围为自变量 ,作多元回归分析。结果　本次调查的OSAHS患者的高血压患病率为 5 0 .5 % ,OSAHS患者的收缩压和舒张压水平明显高于正常对照组 ;OSAHS合并高血压者醒时血压明显高于睡前 ,此外 ,多元线性回归分析示平均血压与年龄呈正相关 (r =0 .4 1,P <0 .0 5 )、与SaO2 min呈负相关 (r =- 0 .4 1,P <0 .0 5 )。CPAP呼吸机治疗 1个月后可显著降低患者的血压。结论　重度OSAHS患者和OSAHS合并高血压者存在着不同的病理生理改变 ,血压增高的程度和高血压患病率会随OSAHS病情加重而逐渐增高 ,CPAP呼吸机治疗 1个月后可明显降低患者的血压

Clinical study on hypertension in obstructive sleep apnea-hypopnea syndrome

Objective To investigate the morbidity of hypertension in obstructive sleep apnea-hypopnea syndrome(OSAHS) and its relationship with the severity of OSAHS. Methods Thirty cases of controls and 111 men with OSAHS were randomly chosen to measure their blood pressure the next morning after recording polysomnography(PSG).Among them,20 moderate to severe patients were treated with continuous airway positive pressure(CPAP) every night and their blood pressure was measured every morning in 30 days. Multiple linear regression was performed with blood pressure as the dependent variables. Parameters included in the analysis were systolic blood pressure(SBP), diastolic blood pressure(DBP), apnea-hypopnea index(AHI), body mass index(BMI), minimal oxygen saturation(SaO 2min), and age. Results The morbidity of hypertension in OSAHS was 50.5%,and it would gradually increase with the severity of OSAHS. SBP and DBP in OSAHS were significantly higher than those of controls. And morning's blood pressure in the patients accompanied with hypertension was also significantly higher than that before sleep. Blood pressure significantly decreased after a month's application of CPAP. Mean BP of OSAHS was significantly correlated positively with age(r= 0.41,P< 0.05)and negatively with SaO 2min(r= -0.41,P< 0.05).Conclusion There were different pathophysiological changes in patients with severe OSAHS and OSAHS accompanied with hypertension.The severity and morbidity of hypertension in OSAHS would gradually increase with the severity of the disease.Blood pressure significantly decreased after a month's CPAP therapy.