OSAHS高血压患者早晨血压高峰出现率及时间研究

发布时间：2018-03-05 19:58

本文选题：阻塞性睡眠呼吸暂停低通气综合征　切入点：高血压　出处：《广西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的研究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypertension syndrome, OSAHS)高血压患者动态血压特点,尤其是早晨血压高峰出现率及出现时间,并分析其相关因素。方法选取2011年1月～2012年12月因打鼾在广西壮族自治区人民医院睡眠呼吸疾病诊疗中心行多导睡眠图(polysomnography, PSG)检测确诊为OSAHS的18-65岁患者为对象,根据是否患有高血压病将OSAHS患者分为OSAHS高血压组、单纯OSAHS组,在高血压病门诊选取无打鼾的高血压病患者为对照1组(单纯高血压组),在体检中心和我院职工中招募无打鼾无高血压者为对照组2组(正常组)。分别对4组人群行24小时动态血压检测并对其数据进行分析,比较4组非杓型血压、早晨血压高峰出现率和出现的时间。结果一、符合条件的213例受试者,平均年龄45.27±10.28岁,男性181例(84.9%),女性32例(15.1%)。其中OSAHS高血压组44例(20.7%),单纯OSAHS组115例(54.0%),单纯高血压组24例(11.3%),正常组30例(14.1%)。各组间年龄差异无统计学意义。颈围OSAHS高血压组、单纯OSAHS组单纯高血压组、正常组,腰围OSAHS高血压组单纯高血压组、单纯OSAHS组及正常组(P均0.05),单纯OSAHS组腰围对照组。体重指数(BMI) OSAHS高血压组单纯OSAHS组单纯高血压组正常组(P均0.05)。二、全天血压变化：OSAHS高血压组比较单纯高血压组全天收缩压更高,以夜间收缩压升高更为明显。OSAHS组的夜间舒张压正常组。三、OSAHS高血压组非杓型血压发生率为86.4%,OSAHS组为79.1%,高血压组为45.8%,正常组为23.3%；OSAHS高血压组早晨血压高峰发生率为84.1%,OSAHS组为50.4%,单纯高血压组为37.5%,正常组为26.7%。早晨血压高峰在OSAHS高血压组5-6AM出现率最高,为86.4%；OSAHS组5-6AM出现率最高,为60.9%；单纯高血压组7-8AM出现率最高,为37.5%；正常组在早晨各时段出现率无差异。结论OSAHS高血压组与单纯OSAHS组、单纯高血压组、正常组全天血压变化规律存在差异,OSAHS高血压组非杓型血压及早晨血压高峰发生率明显增加,OSAHS高血压组、单纯OSAHS组早晨血压高峰出现时间比单纯高血压组出现时间提前。
[Abstract]:Objective to study the characteristics of ambulatory blood pressure (ABP) in patients with obstructive sleep apnea hypertension syndrome (OSAHS), especially the occurrence rate and time of morning peak blood pressure, and to analyze the related factors. Methods Polysomnography (PSG) was performed in the diagnosis and treatment center of sleep apnea disease of Guangxi Zhuang Autonomous region people's Hospital from January 2011 to December 2012. The patients aged 18-65 years who were diagnosed with OSAHS were selected as subjects. OSAHS patients were divided into OSAHS hypertension group and simple OSAHS group according to whether they had hypertension. Hypertension patients without snoring were selected as control group (simple hypertension group) and those without snoring and hypertension were recruited in physical examination center and staff of our hospital as control group 2 (normal group). The group performed 24-hour ambulatory blood pressure testing and analyzed its data. The incidence and time of peak blood pressure in the morning were compared among 4 groups of non-dipper blood pressure. Results 1. The average age of 213 eligible subjects was 45.27 卤10.28 years old. There were 44 cases of OSAHS hypertension group, 115 cases of simple OSAHS group, 24 cases of simple hypertension group, 24 cases of simple hypertension group and 30 cases of normal group. There was no significant difference in age between the two groups. There was no significant difference in age between the two groups. Normal group, waist circumference OSAHS hypertension group, simple OSAHS group and normal group (P 0.05), simple OSAHS group waist circumference control group, body mass index (BMI) OSAHS hypertension group simple OSAHS group simple hypertension group, normal group (P < 0.05). Full-day blood pressure changes: the whole day systolic blood pressure in the 10% OSAHS hypertension group is higher than that in the simple hypertension group. The incidence of non-dipper blood pressure in the OSAHS hypertension group was 79.1, that in the hypertension group was 45.8 percent, and that in the normal group was 23.3OSAHS hypertension group. The morning blood pressure peak rate was 84.1in the OSAHS hypertension group, 79.1in the OSAHS group, 45.8 in the hypertension group, and 23.3OSAHS hypertension group in the normal group. The morning blood pressure peak was the highest in the OSAHS hypertension group, and was the highest in the OSAHS hypertension group. The incidence of 5-6AM was the highest in the OSAHS group (60.9), the highest in the simple hypertension group (37.5%). There was no difference in the incidence of 5-6AM in the normal group. Conclusion there is a significant difference between OSAHS hypertension group and simple OSAHS group, simple hypertension group, normal group. The incidence of non-dipper blood pressure and morning blood pressure peak in OSAHS hypertension group is significantly higher than that in OSAHS hypertension group. The onset time of peak blood pressure in OSAHS group was earlier than that in simple hypertension group.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R766;R544.1

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