短期CPAP治疗对肥胖OSAHS合并高血压患者的降压疗效

Effects of short-term continuous positive airway pressure therapy on obese obstructive sleep apnea hypopnea syndrome patients combined with hypertension

目的探讨短期持续正压通气(CPAP)治疗对肥胖阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者的降压疗效。方法入选2012年11月—2013年5月在新疆维吾尔自治区人民医院高血压科住院确诊的OSAHS合并高血压患者100例,按体重指数(BMI)分为肥胖组(BMI≥28 kg/m2)74例与非肥胖组(BMI<28 kg/m2)26例,维持原有降压方案基础上给予连续每日夜间CPAP治疗(>6 h/晚)1周,监测2组治疗前后每日血压水平,对治疗前后血压,血压下降幅度做组间比较,分析短期CPAP治疗对2组患者降压疗效差异。结果 12组患者在性别构成比例、年龄、呼吸紊乱指数(AHI)、最低血氧饱和度(LSa O2)、CPAP前各血压值差异均无统计学意义(P>0.05);2肥胖组CPAP治疗第7日睡前舒张压[(84.0±10.7)mm Hg vs.(87.3±9.5)mm Hg(P<0.05)]、睡前平均动脉压[(100.1±10.7)mm Hg vs.(104.8±9.2)mm Hg(P<0.05)]均低于非肥胖组,清晨平均动脉压下降幅度[(6.7±9.5)mm Hg vs.(4.6±12.3)mm Hg(P<0.05)]大于非肥胖组。结论短期CPAP治疗对肥胖OSAHS合并高血压患者降压疗效显著。

Objective To explore the effects of short-term continuous positive airway pressure （CPAP） in the treatment of obese obstructive sleep apnea hypopnea syndrome （OSAHS） patients with hypertension. Methods Total 100 OSAHS with hypertension inpatients in our department from November 2012 to May 2013 were enrolled and randomly divided into two groups based on BMI：Obese group with 74 patients （BMI ≥ 28 kg/m2） and Non-obese group with 26 patients （BMI 〈 28 kg/m2 ）. On the basis of pre-existing antihypertensive medications, the nocturnal CPAP therapy was performed for 7 days （ 〉 6 h/night）. The daily blood pressure and changes before and after the treatment were measured and compared between the two groups. Results （~）There were no statistical difference in the gender composition, age, apnea hypopnea index （ AHI）, the lowest oxygen saturation （ LSaO2 ）, the pre-treatment blood pressure （ P 〉 0.05 ）. （2）Post-treatment pre-sleep diastolic blood pressure and pre-sleep mean arterial pressure at day 7 was significantly lower in theobese group than in non-obese group [（84.0 ±10.7） mm Hg vs. （87.3 ±9.5） mm Hg,P〈0.05] and[（100.1 ±10.7）mm Hg vs. （ 104. 8 ± 9.2） mm Hg, P 〈 0. 051. The mean morning arterial pressure decrease range at day 7 was significantly higher in theobese group than in non-obese group[ （6.7 ±9.5） mm Hg vs. （4.6 ±12.3） mm Hg,P〈0.05]. Conclusion The curative effect of short-term CPAP therapy for obese obstructive sleep apnea syndrome patients combined with hypertension is significant.