持续气道正压通气治疗高血压合并阻塞性睡眠呼吸暂停综合征的老年患者疗效评价

Evaluation of continuous positive airway pressure management in elder patients with hypertension and obstructive sleep apnea syndrome

目的探讨高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)的老年患者,接受持续气道正压通气治疗(CPAP)疗效。方法对164例年龄≥60周岁的高血压合并OSAS患者行多导睡眠监测(PSG)和24 h动态血压监测(ABPM),随机分为CPAP联合药物治疗组、CPAP对照组、药物对照组,比较三组治疗后的24 h最高收缩压和最高舒张压。结果(1)三组治疗后最高收缩压和最高舒张压均有下降。(2)CPAP对照组最高收缩压和最高舒张压明显下降(P<0.01)。(3)CPAP联合药物治疗组最高收缩压和最高舒张压下降,优于药物对照组(P<0.01)。结论在高血压合并阻塞性睡眠呼吸暂停综合征的老年患者中CPAP辅助治疗是一个较好的治疗方法。

Aim To investigate whether Continuous Positive Airway Pressure（CPAP） would be effective to elderly patients who suffered with hypertension and obstructive sleep apnea syndrome （OSAS）. Methods 164 patients （ ≥60 years old） with hypertension and OSAS were randomized to 3 groups, treated with CPAP plus hypotensive drugs, CPAP only, and hypotensive drugs only separately. Polysomnography（PSG） and monitoring of ambulatory blood pressure （ABPM） were measured in these patients. The highest systolic and diastolic blood pressure in 24 hours were compared after treatment. Results Both systolic and diastolic pressure were lower after treatment. Patients treated with CPAP obviously had a low systolic and diastolic pressure （P 〈 0.01 ）. Patients treated with CPAP and drugs had a lower highest systolic and highest diastolic pressure than the ones with hypotensive drugs only （P 〈 0.01 ）. Conclusions CPAP is a good treatment to elderly patients with hypertension and OSAS.