nCPAP对阻塞性睡眠呼吸暂停综合征合并高血压患者血压的影响

目的观察经鼻持续气道正压通气(nCPAP)治疗对阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压患者动脉血压的影响。方法将60例符合OSAS合并高血压患者分为实验组30例和对照组30例;对照组采用洛汀新(苯那普利)降压治疗,实验组同时用洛汀新和nCPAP治疗,观察12周,观察治疗前后动脉血压水平、多导睡眠监测结果及脑血流、血液流变学、C反应蛋白的变化。结果与治疗前相比,治疗后两组患者动脉血压均明显下降(P<0.05),但实验组血压下降水平明显优于对照组(P<0.05);治疗后实验组平均睡眠呼吸暂停低通气指数明显下降,平均最低血氧饱和度明显升高,睡眠结构明显改善(P<0.05);实验组血液流变学和C反应蛋白明显下降,脑血流明显改善(P<0.05)。结论nCPAP治疗OSAS并发的高血压可能是一种针对高血压病因的非药物治疗高血压的方法,并可降低血黏度、C反应蛋白,明显改善脑血流,从而可能降低冠心病、脑血管病发生率,改善患者预后。

Influence of nCPAP in patients with OSAS combined with hypertension

Objective To demonstrate the influence of nCPAP on blood pressure in patients with obstructive sleep apnea syndrome (OSAS) combined with hypertension. Methods Sixty obstructive sleep apnea syndrome patients with hypertension were divided into two groups,thirty in the control group and thirty in the experiment group. The control group took benazepril while the experiment group took benazepril and nCPAP. Blood pressure,PSG,TCD,viscosity of blood and CRP were observed before and after treatment.Results After 12-week-therapy, compared with that before treatment, blood pressure was significantly reduced in both groups(P<0.05),but the changes in blood pressure in experiment group were significantly higher than those in control group (P<0.05). Apnea hypopnea index decreased significantly and sleep components improved significantly in the experiment group (P<0.05).Viscosity of blood and CRP of experiment group were decreased significantly and cerebral circulation showed obvious improvement compared with those in control group(P<0.05).Conclusion nCPAP is considered to be an effective and well tolerated method for patients of hypertension with OSAS,and at the same time,nCPAP can decrease the level of CRP and viscosity of blood,improve cerebral circulation,then decrease the incidence of coronary heart disease and cerebrovascular disease, improve the prognosis of patients.