阻塞性睡眠呼吸暂停综合征与高血压的相关性分析

Analysis of the relationship of obstructive sleep apnea syndrome with hypertension

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)与其所导致高血压的相关性.方法对白天嗜睡、打鼾和憋气为主诉的门诊或住院患者行多导睡眠图(PSG)监测,且血压增高达诊断标准患者为研究对象.对睡眠检测结果中的呼吸暂停和低通气指数(AHI)、夜间最低血氧饱和度(SaO2)及睡前、晨起、治疗后的血压进行分析.结果OSAS患者晨起血压较睡前血压增高(P＜0.001),并与SaO2呈负相关(P＜0.05);SaO2与AHI呈负相关(P＜0.05).体重指数与SaO2呈负相关(P＜0.05)与晨起舒张压呈正相关(P＜0.05).经持续气道正压通气(CPAP)治疗、纠正睡眠呼吸暂停6～8周后,晨起血压较治疗前明显下降(P＜0.001).结论OSAS患者肥胖及反复睡眠呼吸暂停与其高血压具有相关性,因此OSAS高血压是一种继发性高血压,CPAP治疗对这种高血压有效.

Objective To explore the relationship of obstructive sleep apnea syndrome（OSAS） with hypertension. Methods Patients who complained of snoring and apnea during sleep and daytime sleepiness were given polysomnography examination （PSG）. Those who had blood pressures coincident with diagnostic criteriaa of hypertension were enrolled. The apnea / hypopnea index （AHI）, nocturnal lowest SaO2 （ SaO2 ）, blood pressures before and after sleep and after treatment with coutinuous positive airway pressure （CPAP） were analyzed. Results The blood pressure of OSAS patients soon after getting up in the morning was significantly higher than that before sleep （ P 〈 0. 001 ）. The diastolic pressure after sleep in the morning was negatively correlated with SaO2 during sleep at night （ P 〈 0.05）. The SaO2 was negatively correlated with AHI （ P 〈 0.05）. The body mass index was negatively correlated with SaO2 （ P 〈 0.05） but positively correlated with the morning diastolic pressure （ P 〈 0.05）. After CPAP for 6 - 8 weeks, the blood pressure after sleep in the morning was significantly decreased as compared with that before treatment （ P 〈 0. 001）. Conclusions The obesity and repeated apnea during sleep was correlated with hypertension in OSAS patients. CPAP treatment was effective for such kind of hypertension.