阻塞性睡眠呼吸暂停合并高血压男性的心脏结构变化及正压通气的治疗作用

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）合并高血压男性患者心脏结构改变及评价持续气道正压通气治疗（continuous positive airway pressure，CPAP）对其的治疗作用。方法23例重度OSAHS合并第一次诊断高血压男性患者，CPAP治疗前后采用人工气道压力滴定试验测定治疗压力，并采用超声心动图测定心脏结构参数，进行比较分析。结果 CPAP治疗前气道治疗压力（9.4±2.3）cmH2O，治疗4周后（8.4±1.8）cmH2O，收缩压CPAP治疗前（143.7±7.7）mmHg，治疗4周后（134±9.2）mmHg，舒张压PAP治疗前（91.4±8.3）mmHg，治疗4周后（84.5±11）mmHg，CPAP治疗后气道压力减轻、血压改善，差异均有统计学意义（P〈0.01）；主动脉内径PAP治疗前（27.4±2.3）mm，治疗4周后（28.9±2.3）mm，差异有统计学意义（P〈0.05）。结论 CPAP治疗不仅能使OSAHS合并高血压男性患者气道压力显著减轻，而且能改善血压、扩大主动脉管径。

ObjectiveTo evaluate the The effect of obstructive sleep apnea-hypopnea syndrome（OSAHS） combined with hypertension on the change of cardiac structure in male and the treatment with continuous positive airway pressure therapy. MethodsTwenty-three patients with newly diagnosed,previously untreated,severe OSAHS（apnea-hyponea index,AHI≥30） and hypertension were included in the study. All patients underwent manual titration of positive airway pressure and echocardiography. Measurements were repeated after 4 weeks of CPAP therapy in patients and were compared with baseline values.ResultsAfter a 4-week course of CPAP therapy,significant decrease was observed in therapy pressure（9.4±2.3 cmH2O vs. 8.4±1.8 cmH2O,P〈0.01）, systolic blood pressure（143.7±7.7mmHg vs 134±9.2 mmHg,P〈0.01）,diastolic blood pressure（91.4±8.3 mmHg vs 84.5±11 mmHg,P〈0.01）and significant increase in aortic root size（27.4±2.3 mm vs. 28.9±2.3 mm;P〈0.05）in patients with OSAHS and hypertension.ConclusionCPAP treatment not only control therapy pressure and blood pressure,but also provided improvement in aortic root size in patients with OSAHS and hypertension.