高血压病合并OSAS患者动态血压与臂踝PWV的变化及其意义

Observation on Ambulatory Blood Pressure and Brachial-ankle Pulse Wave Velocity in Hypertensive Patients with OSAS

【目的】探讨高血压病合并阻塞性睡眠呼吸暂停综合征（OSAS）患者24h动态血压变化与臂踝脉搏波传导速度（baPWV）的关系。【方法】随机选取120侧高血压病患者，其中单纯高血压病60例，高血压病合并OSAS60例，每例均行24h动态血压监测及用动脉硬化自动测量仪检测baPWV。【结果】与单纯高血压病组相比，高血压病合并0SAS组夜间平均收缩压、夜间平均舒张压、非杓型血压发生率、baPwv均增高（P〈0．05或P〈0．01），两组中非杓型血压组baPWV也高于杓型血压组（P〈0．05）。【结论】高血压病合并OSAS患者易引起血压昼夜节律异常，非杓型血压发生率高，且与动脉硬化靶器官损害有关。

[Objective] To explore 24-hour ambulatory blood pressure profile and its relationship to brachial-ankle pulse wave velocity（baPWV） in hypertensive patients with obstructive sleep apnea syndrome （OSAS）. [Methods] Of the 120 enrolled hypertensive patients, 60 had hypertension only and 60 also had hypertension with OSAS. All patients underwent 24 hour ambulatory blood pressure monitoring and measurements of baPWV. [Results]Compared to patients with hypertension only, hypertensive patients with OSAS had sig- nifieantly higher mean night systolic and diastolic blood pressure, higher incidence of non-dipping blood pressure and baPWV （ P 〈0.05 orP〈0.01）. In addition, baPWV was higher in non dippers than that of dippers （ P〈0.05）. [Conclusion]Hypertensive patients with OSAS are apt to occur the circadian change of blood pressure and have higher incidence of non-dipping blood pressure, which are associated with the damages of atherosclerotie target organs.