高血压病合并阻塞性睡眠呼吸暂停的血压昼夜节律研究

研究阻塞性睡眠呼吸暂停对高血压病患血压昼夜节律的影响。方法１８４例研究对象根据诊所血压、２４小时动态血压和多导睡眠图监测结果分为正常对照组、高血压组、高血压病合并轻度或中重度睡眠呼吸暂停组。比较睡眠呼吸暂停指数、睡眠结构对血压昼夜节律的影响。

Study on circadian blood pressure variability in essential hypertensive patients with obstructive sleep apnea

Objective　To demonstrate the influence of obstructive sleep apnea on circadian blood pressure variability in essential hypertensive patients. Methods　One hundred and eighty-four subjects were divided into healthy control,hypertensive, hypertensive with mild obstructive sleep apnea (OSA), and hypertensive with moderate and severe OSA group based on clinical blood pressure measurement, 24-hour ambulatory blood pressure monitoring (ABP) and polysomnography (PSG). Results　In the hypertensive with moderate and severe OSA group, blood pressure of 69.4% patients presented non-dipper profile, and the frequency of non-dipper blood pressure profile in this group was significantly higher than those of other groups (P<0.001). The sleep structure was significantly different in the hypertensive with moderate and severe OSA group from other groups, the time percentages of III and IV sleep phases in the non-rapid eye movement (NREM) sleep stage(9.93%) and the rapid eye movement (REM) stage (12.56%) to the whole sleep stages were significantly lower than those of the other groups. The apnea-hypopnea index (AHI) negatively correlated to the proportion of III and IV sleep phases and REM sleep stage (r=-0.299, P<0.01 and r=-0.229, P<0.05, respectively). Conclusion　The circadian blood pressure variability significantly relates to OSA severity and sleep structure damaged, and the non-dipper blood pressure profile is one of potential risk factors to cardiovascular events in patients with OSA.