男性高血压并阻塞性睡眠呼吸暂停综合征患者左心室重构与血压变异的关系

目的对男性初诊高血压并阻塞性睡眠呼吸暂停综合征(OSAS)患者左心室重构与血压变异进行分析,了解二者的关系。方法采用回顾性分析方法,选择36例男性初诊高血压并OSAS患者为研究组,60例男性初诊原发性高血压患者为对照组。所有入选患者均行动态血压及超声心动图检查。比较24h平均收缩压(24hSBP)/平均舒张压(24hDBP),血压变异性(BPV)及舒张期室间隔厚度(IVST)、左心室后壁厚度(LVPWT)的差异及二者联系。结果 (1)OSAS组的24hDBP、收缩压变异性(SBPV)、舒张压变异性(DBPV)、收缩压变异系数(SCV)、舒张压变异系数(DCV)均高于对照组(P<0.05)。(2)OSAS组的LVIDd、LVISd、IVST及LVPWT均高于对照组(P<0.05)。(3)OSAS组患者IVST与24hSPB、24hDBP、DBPV、SBPV及DCV呈正相关(r=0.596、0.654、0.631、0.627、0.405,P均<0.05)。结论男性高血压并阻塞性睡眠呼吸暂停综合症患者血压变异性较原发性高血压增加,心室重构较原发性高血压明显,心室重构与血压变异性呈正相关。

Relationships between left ventricular remodeling and blood pressure variability in male patients with hypertension and obstructive sleep apnea-hypopnea syndrome

Objective To study the relationship between left ventricular remodeling and blood pressure variability (BPV) in male patients with hypertension and obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Thirty-six male patients with hypertension and OSAHS were selected as the study group, and 60 patients with essential hypertension (EH) were selected as the control group. All the patients were performed 24-hour ambulatory blood pressure monitoring and echocardiogram. The 24-hour systolic/diastolic blood pressure (24 h SBP/24 h DBP), BPV, left ventricular internal diastolic diameter (LVIDd), left ventricular end-systolic diameter (LVISD) and interventricular septal thickness, (IVST), left ventricular posterior wall thickness (LV PWT) were analyzed and compared between the two groups. Results (1) The 24 h DBP, systolic blood pressure variability (SBPV), diastolic blood pressure variability (DBPV), systolic blood pressure coefficient of variation (SCV) and diastolic blood pressure coefficient of variation (DCV) were significantly higher in the study group than the control group (P<0.05). (2) The LVIDd, LVISd, IVST and LV PWT were significantly higher in the study group than the control group (P<0.05). (3) There were positive correlation between IVST and 24 h SBP, 24 h DBP, DBPV, SBPV and DCV in the study group (r=0.596, 0.654, 0.631, 0.627, 0.405, respectively (P<0.05). Conclusion Blood pressure variability is higher in patients with OSAHS, compared with patients with essential hypertension. There is positive correlation between left ventricular remodeling and blood pressure variability.