睡眠呼吸暂停综合征对血压、内皮功能及左室质量的影响

The Impact of Obstructive Sleep Apnea on Blood Pressure,Endothelial Function and Left Ventricular Mass

目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)对动态血压、血管内皮功能及左室质量的影响。方法:将120例有或无OSAS的高血压患者和血压正常者分为4组:对照组(NS组)、高血压组(EH组)、OSAS组及OSAS+EH组,进行动态血压、超声心动图、血一氧化氮(NO)、内皮素(ET)测定。结果:(1)不论有无高血压的OSAS患者,夜间血压下降率<10%,比无OSAS组较多见(P<0.001);且OSAS+EH组血压较EH组高(P<0.05)。(2)OSAS+EH组与OSAS组ET升高,与NS组比较,差异有极显著性(P<0.001)。而OSAS+EH组与OSAS组NO下降,与NS组比较,差异有极显著性(P<0.001)。(3)OSAS+EH组、OSAS组左室质量指数(LVMI)与NS组比较,差异有极显著性(P<0.001),且OSAS+EH组与EH组比较,差异有极显著性(P<0.001)。结论:OSAS患者血压昼夜节律消失,且伴有血管内皮功能紊乱,由此进一步加重对心脏等靶器官的损害。

Objective： To explore the impact of obstructive sleep apnea syndrome（OSAS）on ambulary blood pressure,endothelial function and left ventricular mass.Methods：The ambulary blood pressure,echocardiogram,serum nitric oxide（NO）,plasma concentrations of endothelin（ET）were determined in all patients.Based on patients with or without OSAS,subjects were subdivided as： normal subjects,hypertension alone,OSAS and OSAS alone,and OSAS associated with hypertension.Results：（1）In patients with OSAS BP nocturnal fall was less than that of non-OSAS,plasma ET levels were higher in patients with OSAS＋EH and OSAS group than that in NS group（P〈0.001）,while the serum NO levels were lower（P〈0.001）.（2）LVMI were increased in patients of OSAS＋EH group and OSAS group compared with that of NS group（P〈0.001）.（3）The LVMI difference between OSAS＋EH group and EH group and EH group were also statistically significant（P〈0.001）.Conclusion：The prevalence of non-dipper pattern of BP,endothelia dysfunction in patients with OSAS may contribute to the accentuated damage of target organs.