睡眠呼吸暂停综合征与晨峰血压、心率关系的研究

发布时间：2018-02-26 21:42

本文关键词： 睡眠呼吸暂停综合征晨峰血压心率变异性　出处：《哈尔滨医科大学学报》2014年01期 　论文类型：期刊论文

【摘要】：目的探讨睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)与晨峰血压、心率变异性的关系。方法对64例检查明确为OSAS,且合并原发性高血压的患者行24 h动态血压监测和动态心电图监测,按OSAS合并高血压患者是否合并血压晨峰分为两组:OSAS合并高血压病伴血压晨峰组(晨峰组)33例,OSAS合并高血压病不伴血压晨峰组(非晨峰组)31例,以及同期健康体检人员30例作为对照组,比较3组睡眠呼吸监测结果及血压昼夜节律变化和心率变异性结果。结果晨峰组及非晨峰组和对照组比较,呼吸紊乱指数(AHI)增高(P0.01),最低血氧饱和度降低(P0.01),血压昼夜节律均有明显改变(P0.01);晨峰组和非晨峰组比较,AHI、最低血氧饱和度和血压昼夜节律也有所不同,晨峰组AHI更高(P0.05),最低血氧饱和度更低(P0.05),非杓型血压昼夜节律者明显增多(P0.05)。关于心率变异性,晨峰组及非晨峰组和对照组相比,低频谱、LF/HF增高(P0.05),高频谱、SDNN、PNN50、HRVI降低(P0.05),晨峰组和非晨峰组的HRVI相比也有显著性差异(P0.05),其它指标在数值上也有差异,但差异没有统计学意义(P0.05)。结论 OSAS合并高血压病伴血压晨峰AHI更高,最低血氧饱和度更低,非杓型血压昼夜节律者明显增多,自主神经损伤程度更严重,更容易发生心脑血管不良事件。
[Abstract]:Objective to investigate the relationship between obstructive sleep apnea syndrome (OSAs) and morning peak blood pressure (BBP) and heart rate variability (HRV) in 64 patients with essential hypertension and 24 h ambulatory blood pressure monitoring (ABP) and dynamic electrocardiogram (ECG) monitoring. According to whether the patients with OSAS complicated with hypertension or not, they were divided into two groups: the morning peak group (33 cases), the morning peak group (33 cases), the group of hypertension without the morning peak (31 cases of the non-morning peak group, 31 cases of the non-morning peak group, 31 cases of the morning peak group). The results of sleep respiration monitoring, circadian rhythm of blood pressure and heart rate variability were compared between the morning peak group and the non-morning peak group and the control group. The highest respiratory disorder index (AHII) increased P0.01A, the lowest oxygen saturation decreased P0.01U, and the circadian rhythm of blood pressure was significantly changed, and the lowest oxygen saturation and circadian rhythm of blood pressure were also different between the morning peak group and non-morning peak group, and there was no significant difference between the morning peak group and the non-morning peak group in the lowest oxygen saturation and the circadian rhythm of blood pressure. In the morning peak group, the AHI was higher than that in the morning peak group, the lowest oxygen saturation was lower than that in the control group, and the circadian rhythm of non-dipper blood pressure was significantly increased in the morning peak group than in the control group. As for heart rate variability, the morning peak group and the non-morning peak group were compared with the control group. The HRVI of low frequency peak group was significantly higher than that of non-morning peak group (P 0.05), but the difference of other indexes was not significant (P 0.05). Conclusion the AHI of OSAS with hypertension with morning peak is higher than that of non-morning peak group, but there is no significant difference between them in low frequency spectrum and high frequency range (P = 0.05). Conclusion: there is a significant difference in AHI between morning peak group and non-morning peak group, but there is no significant difference in other indexes (P 0.05). Conclusion OSAS with hypertension has higher AHI in morning peak than that in non-morning peak group. The lowest oxygen saturation was lower, the circadian rhythm of non-dipper blood pressure increased obviously, the degree of autonomic nerve injury was more serious, and the adverse events of cardiovascular and cerebrovascular diseases were more likely to occur.
【作者单位】：哈尔滨市第一医院心内科;
【基金】：黑龙江省卫生厅科研课题(2010-313)
【分类号】：R766

【参考文献】