急性脑梗死合并阻塞性睡眠呼吸暂停综合征患者的夜间血压变异性

发布时间：2018-02-08 21:21

本文关键词： 脑梗死阻塞性睡眠呼吸暂停综合征夜间血压变异性　出处：《广东医学》2017年S1期 　论文类型：期刊论文

【摘要】：目的探讨伴有阻塞性睡眠呼吸暂停综合征(OSAS)的急性脑梗死患者夜间血压变异情况。方法筛选急性脑梗死患者90例,在脑梗死发病后7 d内检查多导睡眠图与动态血压的指标。根据呼吸暂停低通气指数(AHI值),将所有病例分为无OSAS组(AHI5次/h)、轻度OSAS组(AHI 5~15次/h)、中度OSAS组(AHI16~30次/h)和重度OSAS组(AHI30次/h)。分析动态血压监测的夜间收缩压标准差、平均收缩压;夜间舒张压标准差、平均舒张压及其他相关资料的差异,行多元线性回归分析。结果 (1)4组的夜间收缩压标准差、平均收缩压、舒张压标准差的差异有统计学意义(P0.05);4组两两之间夜间收缩压标准差、平均收缩压、舒张压标准差的差异均有统计学意义,夜间s SD、SBP、d SD随着患者OSAS严重程度而增大。4组的夜间平均舒张压组间差异无统计学意义(P0.05)。(2)多元线性回归分析示:AHI、高血压史是夜间收缩压标准差的预测因子,AHI、高血压史标准偏回归系数分别是0.718和0.177,AHI对夜间收缩压标准差的影响最大。(3)NIHSS评分组间差异有统计学意义(F=19.13,P=0.000);进一步组间两两比较的SNK检验,中度OSAS组、重度OSAS组合并脑梗死患者NIHSS评分高于无OSAS组,两两比较差异有统计学意义。结论急性脑梗死合并OSAS患者的夜间收缩压标准差、夜间平均收缩压、夜间舒张压标准差随着OSAS严重程度而升高,且神经功能损伤随着OSAS严重程度有加重趋势。
[Abstract]:Objective to investigate the nocturnal blood pressure variation in patients with acute cerebral infarction with obstructive sleep apnea syndrome (OSAS). Methods 90 patients with acute cerebral infarction were selected. Polysomnography and ambulatory blood pressure were examined within 7 days after the onset of cerebral infarction. According to apnea hypopnea index (AHI), all patients were divided into OSAS free group, mild OSAS group and moderate OSAS group. The standard deviation of systolic blood pressure at night for ambulatory blood pressure monitoring was analyzed. Mean systolic blood pressure, night diastolic blood pressure standard deviation, difference of mean diastolic blood pressure and other related data were analyzed by multivariate linear regression analysis. There were significant differences in the standard deviation of diastolic blood pressure (DBP) between two groups (P 0.05) and the difference of night systolic blood pressure standard deviation, mean systolic blood pressure and diastolic blood pressure standard deviation were all statistically significant. The nocturnal sSD-SBPd SD increased with the severity of OSAS. There was no significant difference in nocturnal mean diastolic blood pressure between groups (P < 0.05). The multivariate linear regression analysis showed that the history of hypertension was a predictor of nocturnal systolic blood pressure standard deviation (NSBP). Hypertension was a predictor of nocturnal systolic blood pressure standard deviation (NSBP). The historical standard partial regression coefficients were 0.718 and 0.177 AHI, respectively, which had the greatest influence on the nocturnal systolic blood pressure standard deviation. There was significant difference between the two groups. There was significant difference between the two groups. The NIHSS score in moderate OSAS group, severe OSAS combination with cerebral infarction group was higher than that in no OSAS group, the difference was statistically significant. Conclusion the nocturnal systolic blood pressure standard deviation and nocturnal mean systolic blood pressure were observed in patients with acute cerebral infarction with OSAS. The standard deviation of night diastolic blood pressure increased with the severity of OSAS, and the nerve function injury tended to increase with the severity of OSAS.
【作者单位】：南方医科大学附属佛山医院(佛山市第二人民医院)神经内科;暨南大学第一附属医院康复科;
【基金】：佛山市卫生和计生局医学科研课题(编号:2015315)
【分类号】：R743.33;R766

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