阻塞性睡眠呼吸暂停低通气综合征合并高血压患者夜间血压变化分析

The study of nocturnal blood pressure fluctuation in patients with obstructive sleep apnea-hypopnea syndrome and hypertension

目的研究阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并高血压患者夜间血压的变化，探讨OSAHS与高血压的相关性。方法选取95例（A组）确诊为OSAHS合并高血压的患者，95例（B组）单纯OSAHS患者为研究对象，分别记录所有患者体质指数、颈围／身高的比值、就诊时血压，完成至少7h的多导睡眠监测（PSG），同时测量睡前血压，夜间血压，醒后即刻血压，并行比较分析。结果两组体质指数和颈围／身高的比例差异无统计学意义；不同严重程度的OSAHS患者的最高血压高低的差异无统计学意义。呼吸紊乱指数（AHI）与醒时即刻-入睡收缩压差值，入睡-睡前舒张压差值无统计学相关性（P〉0．05），与入睡-睡前SBP差值及醒时即刻-入睡舒张压（DBP）差值的差异有统计学意义（P〈0．05）。结论入睡-睡前收缩压及醒时即刻-入睡舒张压的变化与AHI相关。通过夜间不同时点血压测定，避免对病人睡眠状态的打断及影响，有利于对OSAHS患者的心脑血管并发症及预后进行更好的评价。

Objective To study the correlation between the obstructive sleep apnea-hypopnea syndrome （OSAHS） and hypertension by monitoring nocturnal blood pressure fluctuation in patients. Methods 95 patients with OSAHS and hypertension （group A） and 95 patients with OSAHS only （group B） were selected and their body mass index, the ratio of neck circumference and height , the blood pressure at time of visit were recorded. At least 7 hours, polysomnography（PSG） was performed for every patient , meanwhile, the blood pressure before sleep, at night and right after wake-up were also collected. The two groups＇ data was compared and analyzed. Resuits There was no statistical difference in the body mass index and neck circumference/height between the two groups. No significant difference was found in the highest blood pressure in patients with different severity of OS- AHS. There was no statistical correlation between AHI and systolic blood pressure（SBP） difference of sleep and right after wake, so was AHI and diastolic blood pressure （DBP） difference of before sleep and sleep and bedtime （ P 〉 0.05 ）. But there was correlation between AHI and the different value of SBP before sleep and sleep, so is AHI and DBP diference of right after wake and sleep （ P 〉 0.05 ）. Conclusions There is correlation between AHI and the different value of SBP before sleep and sleep, so was AHI and DBP diference of right after wake and sleep. Measure of different time-points blood pressure at night can avoid interrupting the sleep state of patients, will help better evaluate cardiovascular complications and prognosis of patients with OSAHS .