经鼻持续气道正压通气治疗对阻塞性睡眠呼吸暂停综合征合并高血压患者血压的影响

Effect of Nasal Continuous Positive Airway Pressure Treatment on Hypertension of Patients with Obstructive Sleep Apnea Syndrome

目的 探讨经鼻持续气道正压通气治疗对阻塞性睡眠呼吸暂停综合征合并高血压患者血压影响的途径和机理。方法 随机抽取阻塞性睡眠呼吸暂停综合征合并高血压患者 5 9例 ,分为经鼻持续气道正压通气治疗组与对照组 ,观察治疗前与治疗后两组患者血压、多导睡眠图及血糖、血脂、血浆降钙素基因相关肽、内皮素等多项指标变化。结果 ①阻塞性睡眠呼吸暂停综合征合并高血压患者各期血压平均水平与呼吸紊乱次数、呼吸紊乱指数、平均呼吸暂停时间、最长呼吸暂停时间呈正相关。②经鼻持续气道正压通气治疗后治疗组患者PSG参数明显改善 (P <0 .0 1) ;血压明显下降 ,与对照组比较差异有显著性 (P <0 .0 1)。③治疗组经鼻持续气道正压通气治疗 8周后BS、TG、ET明显降低 ,治疗前后差异有显著性变化 ((P <0 .0 1) ,而对照组改变不明显。结论 经鼻持续气道正压通气治疗阻塞性睡眠呼吸暂停综合征 ,不但可以纠正患者的呼吸暂停 ,改善临床症状 。

Objective To analyse the effect of nasal continuous positive airway pressure treatment on the blood pressure of patients with obstructive sleep apnea syndrome combined with hypertension. Methods Fifty-nine cases of patients with OSAS combined with hypertension were selected at random and were classified into two groups:The nCPAP treatment group and the control group. Blood pressure, polysomnographymonitoring, blood sugar, blood-fat, Calcitonin gene relative peptide, ET and other indexes of the two groups were observed before and after the treatment. Results ① There were positive conduction between the average blood pressure of the patients with OSAS combined with hypertension and apnea hypopnea index, obstructive sleep apnea time, long obstructive sleep apnea time. ② The PSG parameter of patients in treatment group has been improved obviously (P<0.01); The blood pressure fell obviously and differences were characteristic (P<0.01).③ After having been treated by nCPAP for eight weeks, BS, TG, ET, of patients in the treatment group fell obviously. Differences are apparent while the changes of control group were not obvious. Conclusion nCPAP treating patients with OSAS can not only improve the clinical symptom of obstructive sleeping apnea but also reduce the blood pressure of patients.