睡眠呼吸暂停综合征对血压、内皮功能及左室质量的影响

目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)对动态血压、血管内皮功能及左室质量的影响。方法:将120例有或无OSAS的高血压患者和血压正常者分为4组:对照组(NS组)、高血压组(EH组)、OSAS组及OSAS EH组,进行动态血压、超声心动图、血一氧化氮(NO)、内皮素(ET)测定。结果:(1)不论有无高血压的OSAS患者,夜间血压下降率<10%,比无OSAS组较多见(P<0.001);且OSAS EH组血压较EH组高(P<0.05)。(2)OSAS EH组与OSAS组ET升高,与NS组比较,差异有极显著性(P<0.001)。而OSAS EH组与OSAS组NO下降,与NS组比较,差异有极显著性(P<0.001)。(3)OSAS EH组、OSAS组左室质量指数(LVMI)与NS组比较,差异有极显著性(P<0.001),且OSAS EH组与EH组比较,差异有极显著性(P<0.001)。结论:OSAS患者血压昼夜节律消失,且伴有血管内皮功能紊乱,由此进一步加重对心脏等靶器官的损害。

The Impact of Obstructive Sleep Apnea on Blood Pressure, Endothelial Function and Left Ventricular Mass

Objective: To explore the impact of obstructive sleep apnea syndrome(OSAS)on ambulary blood pressure,endothelial function and left ventricular mass.Methods:The ambulary blood pressure,echocardiogram,serum nitric oxide(NO),plasma concentrations of endothelin(ET)were determined in all patients.Based on patients with or without OSAS,subjects were subdivided as: normal subjects,hypertension alone,OSAS and OSAS alone,and OSAS associated with hypertension.Results:(1)In patients with OSAS BP nocturnal fall was less than that of non-OSAS,plasma ET levels were higher in patients with OSAS EH and OSAS group than that in NS group(P<0.001),while the serum NO levels were lower(P<0.001).(2)LVMI were increased in patients of OSAS EH group and OSAS group compared with that of NS group(P<0.001).(3)The LVMI difference between OSAS EH group and EH group and EH group were also statistically significant(P<0.001).Conclusion:The prevalence of non-dipper pattern of BP,endothelia dysfunction in patients with OSAS may contribute to the accentuated damage of target organs.