高血压合并阻塞性睡眠呼吸暂停综合征患者的心率变异性分析

Analysis of heart rate variability in patients of hypertension with obstructive sleep apnea syndrome

目的 分析探讨高血压合并阻塞性睡眠呼吸暂停（OSAS）患者的心率变异性（HRV）.方法 将71例高血压病患者根据是否合并OSAS分为：EH组（无合并OSAS）37例及EH＋OSAS组（合并OSAS）34例.比较EH组及EH＋OSAS两组之间呼吸紊乱指数（AHI）、夜间血氧水平、HRV频域指标（SDNN、SDANN、PNN50）与时域指标（低频谱、高频谱、LF/HF）的差异.结果 与EH组相比,EH＋OSAS组的夜间平均血氧及最低血氧水平显著降低（P＜0.05）,而AHI则明显升高（P＜0.05）.SDNN、SDANN及PNN50三个时域指标EH＋OSAS组均高于EH组,但差异均无统计学意义.与EH组相比,EH＋OSAS组LF明显增加（1823.3±265.4比1278.5±239.7,P＜0.05）、HF降低（503.2±163.7比783.6±101.5,P＜0.05）、LF/HF显著增加（4.1±2.2比2.3±2.5,P＜0.01）.结论 OSAS使高血压病患者的心率变异性中频域指标受损.

Objective To analyze the influences of hypertension with obstructive sleep apnea syn- drome （OSAS） on heart rate variability （HRV）. Methods Hypertensive patients （n=71 ） were selected and divided into, according to whether or not complicating OSAS, EH group （without complicating OSAS, n=37） and EH＋OSAS group （complicating OSAS,n=34）. The differences were compared between EH group and EH＋OSAS group in apnea hypopnea index （AHI）, nocturnal blood oxygen level, HRV time domain index （SDNN,SDANN and PNN50） and frequency domain index（ low frequency spectrum,high frequency spectrum and LF/HF）. Results The nocturnal mean and the lowest blood oxygen level of EH＋OSAS group were less than that of EH group significantly（P〈0.05）. AHI in EH＋OSAS group was higher than that in EH group sig- nificantly （P〈0.05）. The differences between EH＋OSAS group and EH group were not significant statistically in HRV frequency domain index（SDNN, SDANN and PNN50） （P〈0.05） . While the differences between the two groups in time domain index （LF, HF and LF/HF） were significant. Conclusion OSAS impaires fre- quency domain index of heart rate variability in hypertensive patients.