阻塞性睡眠呼吸暂停低通气综合征对男性高血压患者血压及高敏C-反应蛋白的影响

Effect of obstructive sleep apnea hypopnea syndrome on blood pressure and high sensitive C-reactive protein in male hypertension patients

目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对男性高血压患者血压与高敏C-反应蛋白(hs-CRP)的影响。方法对188例新确诊的男性高血压患者进行呼吸睡眠监测,并根据呼吸暂停低通气指数(AHI)分为正常对照组(AHI≤5,35例)、轻度OSAHS组(5<AHI≤15,28例)、中度OSAHS组(15<AHI≤30,57例)、重度OSAHS组(AHI>30,68例)。对各组患者进行动态血压监测,同时抽血检查空腹血糖(FPG)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、hs-CRP等指标,并进行分析比较。结果与正常对照组比较,中度和重度OSAHS组患者的TG、hs-CRP均升高(P<0.01,P<0.05),同时,夜间平均收缩压(nSBP)与平均舒张压(nDBP)亦升高(P<0.01,P<0.05),但夜间血压降低百分率则显著降低(P<0.01)。AHI、hs-CRP分别与nSBP、nDBP呈正相关(P<0.01),与夜间血压降低百分率则呈负相关(P<0.01)。结论中重度OSAHS引起夜间血压升高,同时增加机体hs-CRP含量,进一步损害昼夜血压节律。

Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome（OSAHS） on blood pressure and high sensitive C-reactive protein（hs-CRP） in male hypertension patients.Methods A total of 188 newly diagnosed male hypertension patients received sleeping apnea monitor and divided into 4 groups according the hypopnea index （AHI）,control group（AHI≤5,re =35）,mild OSAHS group（5 AHI≤15,n =28）,moderate OSAHS group（15 AHI≤30,n = 57）,and severe OSAHS group（AHI 30,n = 68）.All the patients received ambulatory blood pressure monitor the next day.The blood sample of patients were taken to test fasting blood glucose（FPG）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,hs-CRP.Results Compared with control group,the serum TG and hs-CRP level were significantly higher in moderate and severe OSAHS group patients（P 0.01, P 0.05）.At the same time,compared with control group,the patients had increased mean systolic blood pressure at night （nSBP） and mean diastolic blood pressure at night（nDBP） in these two groups（P 0.01,P 0.05）,as well as the nocturnal blood pressure reduction percentage decreased significantly（P 0.01）.The AHI and hs-CRP were both independently and positively correlated with the nSBP and nDBP.At the same time,they were both independently and negatively correlated with the nocturnal blood pressure reduction percentage.Conclusion Server OSAHS can increase patient＇s blood pressure at night,while increase the serum hs-CRP level and further damaging the circadian rhythm of blood pressure.