妊娠高血压与阻塞性睡眠呼吸暂停低通气综合征的关系研究

Relationship between Gestational Hypertension and Obstructive Sleep Apneahypopnea Syndrome

目的探讨妊娠高血压(GH)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的关系。方法选择55例轻度GH孕妇为A组,23例中、重度孕妇为B组,24例正常孕妇为C组(对照组),分析3组睡眠相关呼吸参数及血压资料。结果 B组平均SaO2、通气指数、体重指数分别为(72.26±5.08)%、(37.21±2.56)次/h、(29.14±2.62)kg/m2,明显高于A组、C组(P<0.05);B组睡眠延迟、稳定的睡眠比、清醒/梦睡眠比分别为(33.2±34.5)min、(36.3±19.1)%、(34.7±8.3)%,睡眠延迟显著高于A、C组,稳定的睡眠比、清醒/梦睡眠比显著低于A、C组(P<0.05);B组24 h收缩压、舒张压,白天收缩压、舒张压,夜间收缩压、舒张压,睡醒后收缩压、舒张压均高于A组、C组(P<0.05);B组杓型比例明显低于A组、C组(P<0.05);B组异常新生儿发生率显著高于A组、C组(P<0.05)。结论 GH与OSAHS关系密切,孕妇血压和供氧等可影响胎儿发育。

Objective To explore the relationship between gestational hypertension（GH） and obstructive sleep apneahypopnea syndrome（OSAHS）. Methods Fifty-five pregnant women with mild GH were selected as group A,23 pregnant women with moderate to severe GH as group B,and 24 normal pregnant women as group C（control group）. The sleep apnea parameters and blood pressure data of three groups were analyzed. Results The average SaO2,ventilation index,body mass index of group B were（72. 26 ± 5. 08）%,（37. 21 ± 2. 56） /h,（29. 14 ± 2. 62）kg /m^2,respectively,which were higher than those of group A,group C（P〈0. 05）. The sleep delay,stable sleep ratio,wake /sleep ratio of group B were（33.2 ±34.5）minutes,（36.3 ±19.1）%,（34.7 ±8.3）%,respectively.The sleep delay of group B was higher than that of group A,group C（P〈0. 05）. The stable sleep and wake /sleep ratios of group B were significantly lower than those of group A and group C（P〈0. 05）. The 24-hour systolic blood pressure,24-hour diastolic blood pressure,daytime systolic blood pressure,daytime diastolic blood pressure,systolic blood pressure at night,diastolic blood pressure at night as well as systolic blood pressure and diastolic blood pressure after waking up of group B were higher than those of group A and group C（P〈0.05）.The proportion of dipper type of blood pressure in group B was significantly lower than that in group A or group C（P〈0. 05）. The incidence of abnormal neonates of group B was significantly higher than that of group A or group C（P〈0.05）.Conclusion GH closely correlates with OSAHS,the blood pressure and arterial oxygen pressure of the pregnant woman might affect the newborn health.