阻塞性睡眠呼吸暂停综合征伴高血压患者睡眠呼吸指数与同步血压特征

发布时间：2018-03-07 23:32

本文选题：阻塞性睡眠呼吸暂停综合征　切入点：高血压　出处：《临床耳鼻咽喉头颈外科杂志》2015年06期 　论文类型：期刊论文

【摘要】：目的:利用PSG阻塞性睡眠呼吸暂停综合征(OSA)伴高血压(HT)患者睡眠呼吸指数及同步血压变化分析其与单纯OSA、HT差异,揭示其变化的特征。方法:PSG与动态血压分别监测2012-2013年确诊的单纯HT(45例)、单纯OSA(50例)及OSA伴HT(56例),比较3组睡眠呼吸参数及同步血压,并行相关性分析。结果:与HT组及OSA组比较,OSA伴HT组AHI增加(P0.01),氧减指数(ODI)、微觉醒指数(AI)、觉醒时间(WASO)及N1期占总睡眠时间(TST)比例显著增多(P0.05),平均血氧饱和度(MSaO2)、最低血氧饱和度(LSaO2)、慢波睡眠期(SWS)及REM期(REM)占TST的比例显著减少(P0.05)。经持续气道正压(CPAP)治疗后,与单纯OSA组比较,OSA伴HT组昼间平均收缩压(dMSP)、昼间平均舒张压(dMDP)、夜间平均收缩压(nMSP)、夜间平均舒张压(nMDP)较治疗前均明显降低(P0.05),昼夜平均收缩压差(△SBP)、昼夜平均舒张压差(△DBP)明显增加(P0.05)。AHI、ODI、AI、WASO及N1期占TST百分比与平均收缩压/舒张压(SBP/DBP)呈正相关(P0.05),与MSaO2、LSaO2呈负相关(P0.05)。血压变化主要发生在REM时相增多的睡眠后期,该血压以DBP升高为显著特征,并伴有SaO2降低。结论:OSA伴HT睡眠呼吸指数与OSA患者差异有统计学意义,与睡眠期血压变化密切相关;AHI是OSA伴HT高危因素;CPAP可显著OSA伴高血压患者昼夜血压。PSG是判断OSA伴HT病程发展和预后有效手段。
[Abstract]:Objective: to analyze the difference of sleep apnea index and synchronous blood pressure between patients with PSG obstructive sleep apnea syndrome (OSA) and patients with hypertension. Methods the changes of HT(45 and OSA(50 in 2012-2013 and OSA with HT(56 were monitored respectively, and the sleep respiration parameters and synchronous blood pressure were compared among the three groups. Results: compared with HT group and OSA group, AHI in OSA with HT group increased P0.01T, OSA decreased oxygen index (ODIN), microarousal index (AAI), awakening time (WASO) and N1 phase in total sleep time (TST) increased significantly (P 0.05), mean oxygen saturation (MSAO _ 2) and lowest oxygen saturation (MSaO _ 2) increased significantly. The proportion of LSaO _ 2 (slow wave sleep phase) and REM phase (REM) in TST decreased significantly (P < 0.05). After continuous positive airway pressure (CPAP) treatment, the ratio of LSaO _ 2 to TST was significantly decreased. Compared with the simple OSA group, the diurnal mean systolic blood pressure (DBP), diurnal mean diastolic blood pressure (DBP), nocturnal mean systolic blood pressure (RBP), nocturnal mean diastolic blood pressure (NDBP) were significantly lower than those in the control group (P < 0.05), and the diurnal mean systolic pressure difference (SBP) was significantly lower than that before treatment. Pressure difference (DBP) significantly increased P0.05N. AHIOOODII-AIWASO and N1% of TST were positively correlated with mean systolic / diastolic blood pressure (SBP / DBP) and negatively correlated with MSaO2LSaO2. The changes of blood pressure occurred mainly in the late stage of REM. The blood pressure was characterized by the elevation of DBP and the decrease of SaO2. Conclusion there is a significant difference in the sleep apnea index between the patients with OSA and the patients with OSA. AHI is a high risk factor for OSA with HT. It is an effective method to judge the course and prognosis of OSA with HT in patients with OSA and hypertension.
【作者单位】：甘肃省人民医院睡眠医学中心;甘肃省人民医院心内科;兰州大学基础医学院;甘肃省永靖县人民医院;
【分类号】：R766;R544.1

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