睡眠呼吸暂停综合征患者动脉血氧饱和度和血压的变化

Changes in arterial blood oxygen saturation and blood pressure in patients with sleep apnea syndrome

目的探讨睡眠呼吸暂停综合征(sleep apnea syndrome,SAS)患者动脉血氧饱和度和血压的变化。方法对100例打鼾者进行Autoset诊疗系统监测及睡前、醒后肘部血压测定,将62例诊断为SAS患者作为SAS组,38例未达到诊断标准者作对照组,对2组患者动脉血氧饱和度(SaO_2)和血压进行监测,同时对33例SAS伴高血压患者治疗1个月,重复上述测定。结果 SAS组睡前血压较晨醒后明显升高(P<0.01),与对照组睡前血压及醒后血压比较呈显著升高(P<0.01),治疗组治疗后SaO_2较对照组显著降低(P<0.01),SAS组有33例(53%)确诊为高血压病,经鼻面罩持续正压通气(CPAP)治疗1个月,有19例患者血压明显下降,其中3例患者血压恢复正常。结论 SAS患者的低氧血症是部分SAS伴发高血压的发病原因,经鼻CPAP治疗有助于SAS患者血压的恢复。

Objective To investigate the effect of sleep apnea syndrome （SAS） on arterial blood oxygen saturation （SaO2 ） and blood pressure changes in patients. Methods One hundred cases with snoring were monitored with the Autoset diagnostic system and their blood pressure was detected both before sleep and after wake-up. Sixty patients diagnosed as SAS were assigned as the SAS group, and 38 patients, who did not meet the diagnostic standards were assigned as the control group. Arterial blood oxygen saturation and blood pressure of the patients in both groups were monitored. Then, one month of medical treatment was given to the patients with SAS combined hypertension, and monitoring of the above indices was made once again. Results The blood pressure of the SAS group monitored before sleep was significantly higher than that after wake-up early morning （P 〈0.01 ）. The blood pressure of the SAS group was prominently higher, when it was compared with that of the control group detected before sleep and wake-up （P 〈 0.01 ）. Arterial blood oxygen saturation of the SAS group was obviously lower than that of the control group （ P 〈 0.01 ）. Thirty-three cases （53%） in the SAS group were confirmed as hypertension patients. After one month of treatment with continuous nasal mask positive pressure venti- lation, prominent drop of blood pressure could be noted in 19 patients, and the blood pressure of 3 patients returned to normal. Conclusion Hypoxemia was assoeiated with the pathogenesis of hypertension in some SAS patients. Continuous nasal mask positive pressure ventilation would enable the blood pressure of SAS patients to recover.