阻塞型睡眠呼吸暂停综合征合并高血压患者动态血压变化的临床研究

目的 :探讨阻塞性睡眠呼吸暂停综合征 (OSAS)合并高血压患者的动态血压变化。方法 :经睡眠呼吸监测确诊后 ,对OSAS合并高血压患者 30例 ,单纯OSAS患者 2 4例进行 2 4h动态血压观察。结果 :(1)两组在性别、年龄、体重指数方面差异无显著性 (P >0 .0 5 ) ;(2 )OSAS合并高血压组的呼吸紊乱指数 (AHI)、血氧饱和度低于 90 %的时间百分比 (STL90 % )等睡眠呼吸检测结果均显著高于单纯OSAS组 ;(3)OSAS合并高血压组 2 4h平均收缩压及舒张压 (ASBP和ADBP)、晨起与睡前收缩压及舒张压 (SBP和DBP)均显著高于单纯OSAS组 ;(4 )OSAS合并高血压组晨起血压较睡前明显增高。结论 :睡眠呼吸紊乱和低氧血症是引起OSAS患者高血压形成的重要因素 ,OSAS合并高血压患者血压整体水平较高 ,晨起舒张压升高尤为明显。

Clinical study about ambulatory blood pressure in patients of obstructive sleep apnea syndrome with hypertension

Objective: To explore the changes of ambulatory blood pressure in patients of obstructive sleep apnea syndrome (OSAS) with hypertension. Method: 30 cases of OSAS with hypertension and 24 cases of simple OSAS confirmed by polysomnography were monitored ambulatory blood pressure in 24 hours. Result: (1)There were no significant difference in the sex, age and body mass index (BMI) between 2 groups;(2)There were significant difference in apnea hyponea index (AHI) and percent of time in saturation lower 90%(STL90%) in the cases of OSAS with hypertension, compared to the simple OSAS; (3) It was significant higher change between the group of OSAS with hypertension and the one of simple OSAS in average pressure of systolic and diastolic stages in 24 hours(ASBP and ADBP), pressure of systolic and diastolic stages(SBP and DBP) before sleeping in the night and just waking in the morning;(4) The morning DBP was higher than the one before sleeping in the group of OSAS with hypertension. Conclusion: Sleep breathing disorder and desaturation are important factors which lead to hypertension in patients of OSAS. It is much higher in the patients of OSAS with hypertension in the total level of blood pressure and especially in diastolic pressure of just waking in the morning.