阻塞性睡眠呼吸暂停低通气综合征合并高血压的临床分析

Clinical study of obstructive sleep apnea hypopnea syndrome(OSAHS) complicated with hypertension

目的探讨不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者高血压的患病状况与病情轻重的关系,明确其血压动态变化规律。方法对247例OSAHS患者和116例原发鼾症患者进行整夜(>7h)睡眠呼吸监测,同时记录患者身高、体重、颈围、睡前、醒后血压,并对上述指标进行统计学分析。结果 OSAHS组醒后血压较睡前明显升高,睡前、醒后收缩压、舒张压均较对照组升高,且OSAHS患者血压随病情加重逐渐升高,最低指脉氧饱和度随病情加重逐渐降低。结论 OSAHS是引起或加重部分高血压的主要病因之一,血压增高的程度和发病率会随着病情加重而逐渐增高。随病情加重,睡时及晨间血压较白天高,OSAHS患者血压昼夜节律消失,呈"非杓形"改变。故应及时诊断,合理、有效治疗。

Objective The aim of this study was to explore the relationship between the occurrence of hypertension in OSAHS patients and severity degree of the disease,and to clear the dynamic changes of blood pressure. Methods There were 247 patients with OSAHS and 116 patients with primary snoring were diagnosed by all night （〉7 hours） sleep-monitoring. The height,weight, neck circumference and blood pressure of patients were recorded,and statistical analysis was conducted about all the above indicators. Results The blood pressure of OSAHS group after waking were significantly higher than that before sleep.Both systolic blood pressure and diastolic blood pressure were higher than that of the control group before going to bed and after waking.The blood pressure of OSAHS patients was increased and that lowest oxygen saturation was decreased with the aggravation of the disease. Conclusion OSAHS is one of the main factors that induce or aggravate hypertension,the level and incidence rate of blood pressure were increased with the aggravation of the disease.With the aggravation of disease,the blood pressure of patients that during sleeping and in morning are higher than that during the day.The rhythm of blood pressure in OSAHS patients is disappeared and shows a ＂non dipper＂ change.Therefore, the patients should be timely diagnosed,and provided with reasonable and effective treatment.