阻塞性睡眠呼吸暂停综合征合并隐性高血压患者左心结构和功能的改变

Effect of masked hypertension on cardiac structure and function of patients with obstructive sleep apnea syndrome

目的比较伴或不伴隐性高血压(MH)的阻塞性睡眠呼吸暂停综合征(OSAS)患者左心结构和功能的变化。方法选择2007年11月至2008年7月本院经多导睡眠监测新诊断OSAS患者,按24h动态血压结果,分为OSAS合并MH组(即OS-AS+MH组,n=18)和单纯OSAS组(即OSAS组,n=25),同时设正常对照组(即N组,n=24)。行超声心动图检查,比较3组间左心结构和功能指标。结果OSAS+MH组左心室心肌质量指数(LVMI)、室间隔厚度(IVS)明显高于OSAS组(P<0.05),左室射血分数(EF)、二尖瓣血流频谱E峰A峰最大流速比值(E/A)与OSAS组相似(P>0.05)。结论OSAS患者若合并MH,左心肥厚更明显,即使诊所血压在正常范围内,也应及时行动态血压监测,以达到对MH的早期诊断与治疗。

Objective To investigate the effect of masked hypertension（MH） on the cardiac structure and function of the patients with obstructive sleep apnea syndrome（OSAS）. Methods Forty three patients with OSAS were divided into OSAS＋ MH group（18 cases） and OSAS group（25 cases） according to the results of 24h ambulatory blood pressure monitoring,24 normal subjects were chosen as control group. The index of cardiac structure and function were achieved with doppler echocardiography and analyzed. Results There was significant difference in left ventricular mass index（LVMI） and interventricular septal thickness （IVST） ,but no significant difference was examined in election fraction（EF） or E/A between them. Conclusion Left ventricular hy pertrophy is obvious and severe in the patients with OSAS,especially in those who are combined with MH.