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目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者窦性心率震荡(HRT)、心脏变时性功能的变化。方法 OSAHS合并高血压组(OH组)68例、高血压组(H组)34例和健康对照组(N组)21例,所有对象行多导睡眠图监测(PSG)、24h动态心电图监测及平板运动试验,分别计算各组HRT的两个参数:震荡初始(TO)与震荡斜率(TS)、心脏变时性功能的两个指标:运动中实测最大心率(HRmax)与年龄预测最大心率(APMHR)之比(rHR)、运动后1min心率恢复值(HRR-1)。结果 OH组TO明显高于H组及N组,TS明显低于H组及N组,差异具有显著性(p<0.05);OH组rHR、HRR-1明显低于H组及N组,差异具有显著性(p<0.05)。TO、TS、rHR、HRR-1在OH组阳性率明显高于H组及N组,组间比较差异有统计学意义(p<0.05)。结论 OSAHS合并高血压患者较单纯高血压患者HRT减弱、心脏变时性功能降低,OSAHS使高血压患者自主神经功能受损加重。
Objective To investigate the changes of sinus heart rate turbulence (HRT) and cardiac chronotropic function in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension. Methods Sixty-eight OSAHS patients with hypertension (OH group), 34 hypertensive patients (H group) and 21 healthy controls (N patients) were enrolled in this study. All patients underwent polysomnography (PSG) monitoring and 24h ambulatory ECG monitoring The treadmill exercise test was used to calculate two parameters of HRT in each group: initial TO and TS, and two indexes of cardiac time-varying sexual function: HRmax and age-predicted maximum heart rate during exercise APRHR), HRR-1 at 1 minute after exercise. Results The TO in OH group was significantly higher than that in H group and N group, the TS was significantly lower than that in H group and N group (p <0.05), while the levels of rHR and HRR-1 in OH group were significantly lower than those in H group and N group Significant (p <0.05). The positive rates of TO, TS, rHR and HRR-1 in OH group were significantly higher than those in H group and N group (p <0.05). Conclusion OSAHS with hypertension in patients with hypertension than in patients with weakened HRT, cardiac function of the chronotropic decline, OSAHS increased autonomic dysfunction in hypertensive patients.