阻塞性睡眠呼吸暂停低通气综合征患者凌晨血压和血液流变学的变化

Changes in blood hemorheology and early morning blood pressure in patients with obstructive sleep apnea-hypoventilation syndrome

目的探讨不同程度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者凌晨血压、血液流变学的变化。方法依据呼吸暂停低通气指数将2006年4月至2007年7月在我科确诊为OSAHS的118例患者分为轻（31例）、中（40例）、重度（47例）3组，同时选择25例健康人作为对照组，记录血氧饱和度〈90％的累积时间占总监测时间的百分比（TS90％），测定血液流变学及凌晨血压升高值。结果OSAHS重度组出现凌晨血压增高的21例（43％），中度组的8例（20％），轻度组1例（3％）；血液流变学各指标值、TS90％值OSAHS组均高于正常对照组（P〈0．05），中度和重度组高于轻度组（P〈0．05），重度组显著高于中度组（P〈0．05）；凌晨血压增高组的血液流变学各指标值均明显高于非凌晨血压增高组（P〈0．05）。结论OSAHS患者血液黏稠度、凌晨血压增高比例、TS90％值随阻塞程度增加而升高，血液流变学的变化与凌晨血压增高相关。

Objective To investigate changes in morning blood pressure surge （MBPS） and blood hemorheology in patients with obstructive sleep apnea-hypoventilation syndrome （OSAHS） of various severity. Methods Total 118 patients with OSHAS diagnosed at the Department of Respiratory Diseases, People＇ s Hospital of Guizhou Province were divided into three groups, i. e. , 31 mild, 40 moderate and 47 severe cases, based on their apnea-hypoventilation index （ AHI）, and 25 healthy persons were selected as controls. Blood hemorheology, oxygen saturation, morning blood pressure surge of the patients, as well as percentage of the time with oxygen saturation more than 90 percent of the total monitoring time （TS90%） were recorded. Results Early morning blood pressure surge was found in 21 cases （43%） with severe, eight （20%） with moderate and one （3%） with mild OSAHS. All indicators of blood hemorheology and TS90% were significantly higher in the patients with OSAHS than those in controls （ P 〈 0. 05 ）, those in moderate and severe OSAHS were significantly higher than those in controls （P 〈0. 05） and those in severe OSAHS was significantly higher than those in moderate and mild OSAHS （ P 〈 0. 05 ）. All indicators of blood hemorheology were significantly higher in those with early morning blood pressure surge than those without it （P 〈 0. 05）. Conclusions Blood viscosity, percentage of early morning blood pressure surge and TS90% in the patients with OSAHS are increased with severity of apnea-hypoventilation, and changes in blood hemorheology correlated with early morning blood pressure surge.