高血压合并阻塞性睡眠呼吸暂停患者CPAP治疗前后血压昼夜节律的变化

发布时间：2018-04-25 20:36

本文选题：持续正压通气 + 高血压　；参考：《中国循证心血管医学杂志》2016年02期

【摘要】：目的探讨高血压(HP)合并阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)患者持续正压通气(CPAP)治疗前后血压昼夜节律的变化。方法选择2011年8月~2015年2月于南京市鼓楼医院集团仪征医院治疗的HP合并OSA患者60例。CPAP治疗前后行24 h动态血压监测,比较患者治疗前后睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(Sa O_2)、平均Sa O_2、24 h平均舒张压(24h DBP),24 h平均收缩压(24 h SBP),白天平均舒张压(d DBP),白天平均收缩压(d SBP),夜间平均舒张压(n DBP),夜间平均收缩压(n SBP)。结果治疗前,AHI、最低Sa O_2和平均Sa O_2分别为(45.2±10.8)次/h、(78.2±1.3)%和(91.2±1.5)%;治疗后为(28.3±8.6)次/h、(85.4±3.2)%和(93.7±1.6)%,治疗后与治疗前相比AHI下降,最低Sa O_2和平均Sa O_2升高,差异具有统计学意义(P均0.05)。治疗后,患者的24 h SBP、24 h DBP、d SBP、d DBP、n SBP及n DBP值均低于治疗前,差异有统计学意义(P均0.05)。结论高血压合并阻塞性睡眠呼吸暂停患者存在血压昼夜变化异常,CPAP治疗可改善患者睡眠质量和血压。
[Abstract]:Objective to investigate the changes of circadian rhythm of blood pressure before and after continuous positive pressure ventilation (CPAP) in patients with obstructive sleep apnea (sleep) complicated with obstructive sleep apnea (OSA). Methods from August 2011 to February 2015, 60 patients with HP combined with OSA who were treated in Yizheng Hospital, Gulou Hospital, Nanjing, were monitored for 24 hours before and after treatment. Before and after treatment, the sleep apnea hypopnea index (AHI), the lowest blood oxygen saturation (SAO) and the SAO _ 2 were compared. The mean systolic blood pressure (DBP) was 24 h after 24 h DBP, the daytime mean diastolic pressure (DBP) was 24 h, the daytime mean systolic pressure (DBP) was 24 h, and the daytime mean systolic blood pressure (DBP) was 24 h. The mean diastolic blood pressure (DBP) and the nocturnal mean systolic blood pressure (SBP) were measured. Results before treatment, the lowest SAO _ 2 and average sa _ O _ 2 were 45.2 卤10.8 and 78.2 卤1.3% and 91.2 卤1.5%, respectively; after treatment, they were 85.4 卤3.2% and 93.7 卤1.6%, respectively. After treatment, the levels of AHI decreased, the lowest sa / o _ 2 and average sa _ 2O _ 2 increased (P < 0.05). After treatment, the values of SBP and n DBP in 24 h SBPN and 24 h SBPD were lower than those before treatment, and the difference was statistically significant (P < 0 05). Conclusion there is abnormal diurnal change of blood pressure in patients with hypertension and obstructive sleep apnea. CPAP can improve sleep quality and blood pressure.
【作者单位】：南京市鼓楼医院集团仪征医院呼吸内科;宜兴市人民医院心血管内科;
【基金】：无锡市卫生局科研立项项目(MS201535)
【分类号】：R544.1;R766

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