原发性高血压伴阻塞性睡眠呼吸暂停低通气综合征患者左心室肥厚及其功能改变的危险因素

发布时间：2018-11-16 14:36

【摘要】：目的探讨原发性高血压伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者左心室肥厚(LVH)及其功能改变的危险因素。方法选取2011年1月至2014年1月就诊于新疆医科大学第一附属医院的高血压患者499例,男性321例,女性178例,根据睡眠呼吸暂停低通气指数(AHI)分为4组:AHI5次/h为单纯高血压组(EH组,n=24)、5~15次/h为高血压伴轻度OSAHS组(轻度组,n=208)、15~30次/h为高血压伴中度OSAHS组(中度组,n=156)、AHI30次/h为高血压伴重度OSAHS组(重度组,n=111)。采用心脏超声心动图测定左心室相关参数与收缩、舒张功能,并对比各组左心室相关参数,对研究资料进行单因素方差分析和多因素Logistic回归分析影响左心室结构及其收缩、舒张功能的因素。结果中、重度OSAHS组左心室舒张末内径(LVEDD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室质量指数(LVMI)高于轻度OSAHS组及单纯高血压组;二尖瓣血流频谱舒张早期最大血流速度/舒张晚期最大血流速度(E/A)低于轻度OSAHS组及单纯高血压组(1.01±0.32、0.95±0.28比1.15±0.33、1.28±0.21;P0.05);重度OSAHS组左心室射血分数(LVEF)低于轻度OSAHS组[(63.84±3.71)%比(65.40±3.27)%,P0.05]。多因素Logistic回归分析结果显示,性别(OR=0.240)、血压未达标(OR=2.256)、AHI(OR=2.115)为LVMI的影响因素;AHI(OR=2.212)为LVEF的影响因素;年龄(OR=2.723)、血压未达标(OR=1.627)、AHI(OR=1.786)为E/A的影响因素。结论女性、血压、AHI为LVH的危险因素;AHI为左心室收缩功能的危险因素;年龄、血压、AHI为左心室舒张功能的危险因素。
[Abstract]:Objective to investigate the risk factors of left ventricular hypertrophy (LVH) and its functional changes in patients with essential hypertension with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 499 patients with hypertension, 321 males and 178 females, were selected from January 2011 to January 2014 in the first affiliated Hospital of Xinjiang Medical University. According to the sleep apnea hypopnea index (AHI), the patients were divided into 4 groups: AHI5 / h was simple hypertension group (EH group, n = 24), and 5 minutes / h was hypertension with mild OSAHS group (mild group, n = 208). 30 times / h were hypertension with moderate OSAHS (moderate group, nong156), and AHI30 times / h were hypertension with severe OSAHS (severe group, n = 111). Left ventricular related parameters and systolic and diastolic function were measured by echocardiography, and left ventricular related parameters were compared. Univariate ANOVA and multivariate Logistic regression analysis were used to analyze the left ventricular structure and its contraction. Factors of diastolic function. Results the left ventricular end-diastolic diameter (LVEDD),) and left ventricular posterior wall thickness (LVPWT),) in severe OSAHS group were higher than those in mild OSAHS group and hypertension group. The peak early diastolic / late diastolic maximal flow velocity (E / A) of mitral valve flow spectrum was lower than that of mild OSAHS group and simple hypertension group (1.01 卤0.32 卤0.28 vs 1.15 卤0.33 卤1.28 卤0.21 P 0.05). The left ventricular ejection fraction (LVEF) in severe OSAHS group was lower than that in mild OSAHS group [(63.84 卤3.71)% vs (65.40 卤3.27)%, P0.05]. Multivariate Logistic regression analysis showed that sex (OR=0.240) and blood pressure substandard (OR=2.256), AHI (OR=2.115) were the influencing factors of LVMI (; AHI (OR=2.212). Age (OR=2.723) and blood pressure substandard (OR=1.627), AHI (OR=1.786) were the influencing factors of E / A. Conclusion in women, blood pressure and AHI are risk factors of LVH, AHI is risk factor of left ventricular systolic function, age, blood pressure and AHI are risk factors of left ventricular diastolic function.
【作者单位】：新疆医科大学第一附属医院高血压科;新疆医科大学第一附属医院呼吸二科;
【分类号】：R544.11;R766

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