男性鼾症患者体重超重与正常者血压、血脂、血尿酸的差异及护理

Differences of blood pressure, serum lipid and uric acid between overweight and normoweight snorers in men and the clinical nursing measures

目的探讨男性鼾症患者中体重超重与体重正常者的血压、血脂、血尿酸的差异，为临床护理提供依据。方法2004年4月-2005年3月查体患者中的男性鼾症者共302例，分为体重超重组[210例，体质指数（BMI）≥25kg／m^2]，和体重正常组[（92例），BMI〈25kg／m^2]，分别测定血压、血脂、血尿酸、血红细胞、血红蛋白并进行统计学处理。结果体重超重组舒张压（87．81±11．56）mmHg、甘油三酯（2．99±3．14）mmol／L、血尿酸（384．68±137．76）mmol／L、血红蛋白（157．62±11．94）g／L、血红细胞（4．97±0．41）×10^120／L均高于体重正常组，t值分别为4．537（P=0．000）、3．332（P=0．001）、2．890（P=0．004）、3．542（P=0．000）、3．588（P=0．000）；高密度脂蛋白胆固醇（1．18±0．32）mmol／L低于体重正常组（1．35±0．27）mmol／L，t值为-4．245（P=0．000）均有显著性差异。2组问收缩压、血总胆固醇、低密度脂蛋白胆固醇均无显著性差异，t值分别为1．968（P=0．050）、-0．922（P=0．357）、-0．547（P=0．585）。结论在对男性鼾症患者的护理中应根据体重不同，采取不同的护理措施和健康指导，尤其是在肥胖的鼾症者中，应特别注意控制舒张压、甘油三酯、血尿酸，提高高密度脂蛋白胆固醇；要积极治疗鼾症，预防夜间低氧血症，防止血红细胞进一步增多。

Objective To investigate the differences of blood pressure, serum lipid, uric acid and hemoglobin between overweight and normoweight male snorers,and to provide the evidence for clinical nursing. Methods 302 male snorers aged 19-78（mean 47.48±8. 68） years received medical history inquiring, physical examination, measurements of their height and weight, and measurement of blood pressure（ mercury sphygrnornanometer,two readings taken, the average of those readings obtained）, then the body mass index （BMI） was calculated. Snorers were divided into two groups according to their BMI：Group 1 = overweight snorers（BMI≥25.0 kg/m^2 ,210 snorers）,Group 2= normoweight snorers（BMI 18. 5-24. 9 kg/m^2, 92 snorers）. Blood pressure,serum lipid, uric acid, red blood cell and hemoglobin between the normoweight and overweight groups were measured and statistically analyzed. Results Diastolic blood pressure（DBP,87. 81±11. 56 mmHg）, triglycerides（TG,2.99±3. 14 mmol/L） ,uric acid（UA,384.68±137.76 mrnol/L） ,hemoglobin（Hb,157. 62±11. 94 g/L） ,red blood celI（RBC,4. 97±0. 41 × 10^12/L） in the overweight group were significantly higher than those in the normoweight group（DBP 81.33±10. 95 mmHg, t = 4. 537,P = 0. 000; TG 1.86±1.16mrnol/L, t = 3. 332, P = 0. 001 ; UA 328. 01, t = 2. 890,P = 0. 004 ; RBC 4. 76±0. 57 × 10^12/L, t = 3. 588,P = 0. 000）. Overweight snorers had significantly lower serum high-density lipoprotein cholesterol（HDL-ch） levels compared to normoweight snorers（1.18±0. 32 vs 1.35±0. 27 mmol/L, t =- 4. 245,P = 0. 000）, showing a significant differenc, There were no significant differences in systolic blood pressure（SBP）,total serum cholesterol（TCh） ,lowdensity lipoprotein cholesterol（LDL- ch） between the two groups （t=1.968,P =0. 050;t = 0. 922,P = 0. 357;t = 0. 547 ,P = 0. 585 ; respectively）. Conclusions It is necessary to take different nursing measures and health guidance for male snorers based on their different BMIs in clinical nursing, especially in controlling of diastolic blood pressure,serum triglycerides and uric acid,and in increasing HDL--ch in overweight snorers,and to treat snoring to prevent nocturnal hypoxia and increasing of erythrocytes in male obese snorers.