阻塞性睡眠呼吸暂停综合征与无高血压患者睡眠血压的关系

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)的严重程度和无高血压患者的昼夜血压变化之间的关系。方法连续对60个无高血压收缩压(SBP)<140mm Hg和/或舒张压(DBP)<90mm Hg)]的门诊患者进行通宵的多导睡眠监测(PSG)和动态血压监测(ABPM)。根据从PSG结果计算的睡眠呼吸暂停低通气指数(AHI)将患者分为四组:非OSAS组,轻度组,中度组,重度组。结果昼夜收缩压和舒张压显示在OSAS的严重程度上没有差异;然而,睡眠SBP,最低SBP,醒前SBP在重度OSAS组显著高于非OSAS组(分别P=0.02,P=0.04,P=0.006)。重度OSAS的睡眠BPD、最低BPD、醒前BPD的显著高于非OSAS(P=0.01,P=0.02,P=0.0003)。结论轻中度OSAS患者夜间血压水平和非OSAS患者无显著差别,血压昼夜显示的OSAS的严重性没有区别。然而,严重的OSAS组显示有显著的睡眠血压变化。

Relationship between Obstructive Sleep Apnea Syndrome and Nocturnal Blood Pressure of Patients without Hypertension

Objective To explore the relationship between the severity of obstructive sleep apnea syndrome (OSAS) and circadian blood pressure variation of patients without hypertension. Methods Sixty outpatients without hypertension systolic blood pressure (SBP) <140 mm Hg and/or diastolic blood pressure (DBP) <90 mm Hg] received the overnight polysomnography (PSG) and ambulatory blood pressure monitoring (ABPM) continuously. The patients were divided into four groups based on the apnea-hypopnea index (AHI) calculated by PSG results: non-OSAS group, mild group, moderate group and severe group. Results The circadian systolic and diastolic blood pressure levels displayed no difference in the severity of OSAS, while the nocturnal SBP, lowest SBP and SBP before waking in the severe OSAS group were significantly higher than those in the non-OSAS group (P = 0.02, P = 0.04, P = 0.006, respectively). The nocturnal BPD, lowest BPD and BPD before waking in the severe OSAS group were significantly higher than those in the non-OSAS group (P = 0.01, P = 0.02, P = 0.0003, respectively). Conclusions The nocturnal blood pressure levels have no significant difference in the patients with mild OSAS, moderate OSAS and non-OSAS, and circadian blood pressure levels show no difference in the severity of OSAS. However, the severe OSAS group show significant changes of nocturnal blood pressure.