CPAP对高血压合并阻塞性睡眠呼吸暂停低通气综合征的治疗作用

Therapeutical effect of CPAP on hypertension accompanied by obstructive sleep apnea and hypoventilation syndrome

目的探讨持续上气道正压通气(CPAP)对高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的治疗作用。方法高血压合并OSAHS患者60例,分为治疗组30例和对照组30例,对照组采用药物降压,治疗组在药物治疗的同时进行CPAP治疗4周,采用同步夜间多导睡眠图(PSG)检查和24h动态血压(ABP)检测方法,记录治疗前1d和治疗4周后的血压、呼吸暂停低通气指数(AHI)、非杓型血压曲线的比例。结果治疗组较对照组及自身治疗前24h平均动脉收缩压(SBP)、24h舒张压(DBP)、夜间收缩压(nSBP)、夜间舒张压(nDBP)下降(P<0.01),AHI下降(P<0.01),非杓型曲线的比例下降(P<0.05)。结论对于高血压与OSAHS并存的患者,CPAP可以减轻患者呼吸阻塞的程度,有效地降低血压,恢复血压的昼夜节律。

Objective To investigate the therapeutic effect of countinous positive airways pressure （CPAP） on hypertension and obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods 60 patients with hypertension and OSAHS were divided into two groups of 30 each. Blood pressures, apnea hypopnea index （AHI） and non-dipper type blood tesion curves were monitored on the days right before and after a 4-week treatment by examining their polysomnography （PSG） and ambulatory blood pressures （ABP）. All the patients were given normal medication while the therapeutic group received additional CPAP treatment for 4 weeks. Results 24-hour systolic blood pressures（SBP）, 24-hour diastolic blood pressures （DBP）, night systolic blood pressures （nSBP） and night diastolic blood pressures（nDBP） in the therapeutic group were significn antly lower than those in the control group and those 24h before treatment（P〈0.01）, so were the AHI and the proportion of non-dipper type hypertensions （P〈0.05）. Conclusion CPAP has positive therapeutic effect on patients with hypertension and OSAHS.