阻塞性睡眠呼吸暂停低通气综合征与高血压及瘦素的关系

目的 研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压及瘦素的关系,初步探讨睡眠呼吸紊乱及瘦素在OSAHS并发高血压发病中的作用.方法 测定60例OSAHS及40例年龄、体质指数(BMI)相匹配对照组睡前及醒后血压(BP)、醒后心率(HR),血清瘦素(LEp)水平,同时测定BMI、颈围(NC)、腰臀比(WHR)、血清空腹血糖(FBG)、三酰甘油(TG)、胆固醇(Chol)、空腹真胰岛素(TI)水平.对比两组睡前、醒后BP变化;分析睡眠呼吸紊乱参数及瘦素与高血压的相关关系.结果 OSAHS组与对照组睡前血压差异无显著性(P>0.05),但醒后血压尤其是舒张压(89.75±2.04)mmHg显著高于对照组(81.63±1.91)mmHg并独立于年龄和肥胖(P<0.01);OSAHS组DBP与瘦素、呼吸暂停低通气指数(AHI)呈正相关(r=0.282,P<0.05;r=0.318,P<0.01);BMI(P=0.029)、醒后HR(P=0.030)及瘦素(P=0.049)可能是高血压发生的独立相关因素.结论 睡眠呼吸紊乱可能对醒后血压,尤其是醒后舒张压产生独立的效应;而BMI、醒后HR和瘦素可能是高血压的独立相关因素.

Roles of Hypertension and Serum Leptin in Obstructive Sleep Apnea Hypopnea Syndrome

Objective To explore the roles of hypertension and serum leptin in obstructive sleep ap-nea hypopnea syndrome (OSAHS). Methods Totally 60 patients with OSAHS (OSAHS group) and 40 age-and body mass index ( BMI) -matched non-OSAHS individuals ( non-OSAHS group) were enrolled in this study. The neck circumference (NC), waist/hip rate (WHR) , systolic blood pressure (SBP), diastolic blood pressure (DBP) , leptin, fasting blood glucose (FBG), triglyceral (TG) , cholesterol (Choi) , and true insulin (TI) were measured before and after sleep . The correlations between hypertension/serum leptin level and OS-AHS were analyzed. Results The blood pressure (in the morning) , especially DBP was significantly higher in OSAHS group than in non-OSAHS control group (89.75 ± 2.04) mmHg υs. (81.63 ± 1.91) mmHg, P < 0.01]. DBP in OSAHS group was positively correlated with serum leptin and apnea hypopnea index ( AHI) (r = 0. 282, P < 0. 05; r = 0. 318, P < 0. 01). Logistic regression analysis showed that BMI ( P = 0. 029 ) , heart rate in the morning (P = 0. 030 ) , and leptin ( P = 0. 049 ) were independently correlated with the develop-ment of hypertension. ConclusionsOSAHS may independantly affect blood pressure, especially DBP, after waking up. BMI, HR in the morning, and serum leptin may be the independent correlates of hypertension.