论文部分内容阅读
目的:观察分析高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)患者的动态血压(ABP)变化。方法:选择2008～2010年我科住院诊治的高血压患者80例,对其进行多导睡眠仪及动态血压监测。据结果分为高血压病(EH)组(15例),EH合并OSAS组(40例),单纯OSAS组(25例)。结果:与EH组相比,OSAS组及EH合并OSAS组血压昼夜节律消失比例明显升高(40.2%比60.6%比80.4%,P<0.05),睡眠呼吸紊乱指数(AHI)[(4.0±0.4)比(13.3±4.6)比(18.0±8.0)]、血氧饱和度减少时间[(80.6±12.8)s比(116.1±9.8)s比(131.0±16.8)s]明显增加,最低血氧饱和度[(0.83±0.09)%比(0.74±0.08)%比(0.73±0.09)%]明显降低(P均<0.05),而OSAS组及EH合并OSAS组两组间这些指标无显著差异(P>0.05)。EH合并OSAS组血压[收缩压(159.5±15.1)mmHg,舒张压(105±9.3)mmHg]显著高于EH组的血压[收缩压(147±10.3)mmHg,舒张压(91.8±5.4)mmHg],P<0.05。结论:患睡眠呼吸暂停综合征后,血氧饱和度明显降低,血压昼夜节律消失增加。高血压合并阻塞性睡眠呼吸暂停综合征组的血压显著高于高血压组,说明睡眠呼吸紊乱可加重高血压。
Objective: To observe the changes of ambulatory blood pressure (ABP) in patients with hypertension and obstructive sleep apnea syndrome (OSAS). Methods: From 2008 to 2010, 80 cases of hypertensive patients admitted to our hospital were selected for polysomnography and ambulatory blood pressure monitoring. According to the results were divided into hypertension (EH) group (15 cases), EH with OSAS group (40 cases), simple OSAS group (25 cases). Results Compared with EH group, the rate of disappearance of circadian rhythm of blood pressure in OSAS group and EH combined with OSAS group was significantly higher than that in EH group (40.2% vs 60.6% vs 80.4%, P <0.05), and the AHI [(4.0 ± 0.4) (13.3 ± 4.6) vs (18.0 ± 8.0)], the time of oxygen saturation reduction [(80.6 ± 12.8) s vs (116.1 ± 9.8) s vs (131.0 ± 16.8) s] (0.83 ± 0.09)% (0.74 ± 0.08)% (0.73 ± 0.09)%] (P <0.05). However, there was no significant difference between OSAS group and EH with OSAS group (P > 0.05). The systolic blood pressure (systolic blood pressure (159.5 ± 15.1) mmHg and diastolic blood pressure (105 ± 9.3) mmHg] were significantly higher in the EH with OSAS group than those in the EH group [systolic blood pressure (147 ± 10.3) mmHg and diastolic blood pressure (91.8 ± 5.4) , P <0.05. Conclusion: After suffering from sleep apnea syndrome, the oxygen saturation decreased significantly and the circadian rhythm of blood pressure disappeared. Hypertension with obstructive sleep apnea syndrome group of blood pressure was significantly higher than the hypertension group, indicating that sleep-disordered breathing can aggravate hypertension.