OSAHS与高血压关系观察

Clinical Study on Hypertension in Patient With Obstructive Sleep Apena Hypoventilation Syndrome

目的测定阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者醒时血压,探讨其高血压的发病状况与病情轻重的关系。方法随机抽取30例正常人、111例OSAHS患者进行整晚多导睡眠图检查,次晨醒后马上测定血压。结果OSAHS患者的收缩压和舒张压明显高于正常对照组,重度OSAHS患者的收缩压和舒张压高于轻度和中度者,OSAHS合并高血压者醒时血压明显高于睡前。111例OSAHS患者的高血压患病率为51%,其中轻度26.0%,中度37.0%,重度61.0%,多元线性回归示平均血压与年龄呈正相关(r=0.41,P<0.05),与SaO2min呈负相关(r=-0.41,P<0.05),CPAP呼吸机治疗一个月后患者血压降低明显。结论重度OSAHS患者和OSAHS合并高血压者存在着不同的病理生理改变,OSAHS患者高血压发病率与低血氧相关,血压增高的程度和发病率会随着病情加重而逐渐增高,CPAP呼吸机治疗一个月后可明显降低血压。

Objective To investigate the morbidity of hypertension in patients with obstructive sleep apnea hypoventilation syndrome（OSAHS） and its relationship with the severity of OSAHS. Methods Thirty healthy subjects and 111 men with OSAHS were randomly selected to record polysomnography（PSG） and their blood pressure at the next morning was measured and analyzed. Results SBP and DBP in patients with OSAHS were significantly higher than those of the controls, their hypertension prevalence was .51% and it would gradually increase with the severity of OSAHS. The hypertension incidences of the mild, moderate and severe OSAHS were 26%, 37%, and 61% respectively. The case with severe OSAHS showed higher systolic and diastolic BP than those of the mild and moderate cases, and their blood pressure during morning awake was also significantly higher than before sleep. Blood pressure significantly decreased after a month application CPAP. MBP of OSAHS were significantly correlated with age （r=0.41, P〈0.05） and SaO2min（r=-0.41, P〈0.05）. Conclusions There are different pathophysiological mechanisms in patients with severe OSAHS and OSAHS complicated with hypertension. The hypertension of OSAHS is closely related with hypoxia. And the severity and morbidity of hypertension in OSAHS gradually increase with the severity of the disease. Blood pressure significantly decreases after one month CPAP therapy.