男性高血压并阻塞性睡眠呼吸暂停综合征患者综合干预效果分析

目的 对男性高血压并阻塞性睡眠呼吸暂停综合征(OSAS)患者进行综合干预的效果分析.方法 36例男性高血压并OSAS患者,药物治疗16例,为对照组；结合生活方式干预20例,为观察组.随访6个月前后比较生活习惯,血液生化资料及动态血压,超声心动图,睡眠呼吸多导图参数变化.结果 ①干预后观察组患者吸烟、肥胖及高盐高脂饮食、饮酒率均降低,P＜ 0.05.每周到达有效运动的患者增加,P＜0.01.②干预后两组患者血压水平下降,P＜0.05.③干预后观察组患者BMI及血TC、TG、LDL、Cr浓度明显下降,P＜ 0.01.24 h尿总蛋白及微量白蛋白明显下降,IVST及SBPV、DBPV均变小,P＜ 0.01.④干预后观察组患者夜间低通气指数、呼吸暂停低通气指数、呼吸暂停时间及夜间觉醒时间变小,P＜ 0.05.结论 综合干预治疗可有效减少男性高血压并OSAS患者的心血管危险因素,减轻心脏及肾脏靶器官损害.

The comprehensive intervention effect of male hypertensive patients with obstructive sleep apnea syndrome

OBJECTIVE To analyze the comprehensive intervention effect of 36 cases of male hypertensive patients with obstructive sleep apnea syndrome(OSAS).METHODS We recruited 36 male patients with hypertension and OSAS,16 cases received pharmacotherapy were as control group,20 cases combined with life-style were as observation group.Compared their data of living habits,blood biochemical,ambulatory blood pressure and echocardiography before comprehensive intervention and after 6 months of follow-up.RESULTS ① After the intervention,the rates of smoking,obesity and high salt/fat diet,drinking in patients were decreased(P﹤0.05).The rates to reach the effective movement in a week in patients were increased(P﹤0.01).② After the intervention,the rates of blood pressure levels of two groups were decreased(P﹤0.05).③ After the intervention,the rates of BMI,and blood of the TC,TG,LDL,Cr and 24-hour urine total protein and albumin in the observation patients decreased significantly(P﹤0.05),and IVST,SBPVand DBPV were smaller(P﹤0.01).④ Apnea hyponea index AHI in the observation decreased(P﹤0.05).CONCLUSION The comprehensive intervention can effectively reduce the cardiovascular risk factors in male hypertension with OSAS and reduce the damage of cardiac and renal target organ.