阻塞性睡眠呼吸暂停综合征合并高血压患者的动态血压状况分析

Analysis of ambulatory blood pressure of patients with obstructive sleep apnea syndrome combined with hypertension

目的分析阻塞性睡眠呼吸暂停综合征合并高血压患者的动态血压状况。方法将2014年7月~2015年11月入住我院的85例阻塞性睡眠呼吸暂停综合征合并高血压患者作为研究组,按监测结果分为高血压合并轻度OSAS组（25例）,高血压合并中度OSAS组（27例）以及高血压合并重度OSAS组（33例）,另外选取45例单纯高血压患者作为对照组,采用多导睡眠仪进行动态血压监测,两组患者动态血压情况以及睡眠情况,并对结果进行分析比较。结果非杓型和反杓型高血压曲线、血压晨峰现象均以高血压合并重度OSAS组最常见,其次为中度异常者,高血压合并中度、重度OSAS组的夜间平均收缩压较高,高血压合并轻度OSAS组升高,高血压合并重度组患者的日间平均收缩压（152.1±17.6）mm Hg、夜间平均舒张压（91.2±12.5）mm Hg,明显高于轻度组患者,差异均有统计学意义（P〈0.05）;研究组患者的dSBP、dDBP高于对照组,但差异无统计学意义（P〉0.05）;研究组患者的nSBP、nDBP明显高于对照组,差异有统计学意义（P〈0.05）;研究组患者的AHI、SpO_2、呼吸暂停累计时间等睡眠指标均明显高于对照组,差异有统计学意义（P〈0.05）。结论随着OSAS的加重,高血压患者夜间收缩压明显升高,非杓型高血压发生率明显升高,从而加重了对动脉血管的损害,需要给与及时诊断和治疗。

Objective To analyze the ambulatory blood pressure of patients with obstructive sleep apnea syndrome combined with hypertension. Methods 85 cases of patients with obstructive sleep apnea syndrome combined with hypertension were selected as study group, which were cured in our hospital from July 2014 to November 2015. According to the monitoring results, they were divided into hypertension and light OSAS group（25 cases）, hypertension and moderate OSAS group（27 cases）, and hypertension and severe OSAS group（33 cases）. In addition, 45 cases of patients with simple hypertension were selected as control group. Polysomnography was used to record the ambulatory blood pressure. Ambulatory blood pressure condition and sleep condition of the two groups were compared. Results Non-dipper and anti-dipper hypertensive curve, morning surge in blood pressure were most common in hypertension and severe OSAS group. Moderate anomalies followed by. Mean systolic blood pressure at night of hypertension and moderate OSAS group were higher and it was increased in hypertension and light OSAS group. Mean systolic blood pressure day time and mean diastolic blood pressure at night of hypertension and severe OSAS group was（152.1±17.6） mm Hg and（91.2±12.5） mm Hg, which were significantly higher than those of hypertension and light OSAS group, and the differences were statistically significant（P 0.05）. The dSBP, dDBP of study group were higher than those of control group, but the differences were not statistically significant（P 0.05）. The nSBP, nDBP of study group were significantly higher than those of control group,and the differences were statistically significant（P 0.05）.The AHI, SpO_2, cumulative duration of apnea and other sleep indexes of study group were significantly higher than those of control group, and the differences were statistically significant（P 0.05）. Conclusion With the aggravation of OSAS, systolic blood pressure at night of patients with hypertension was significantly increased. The incidence of non-dipper hypertension was significantly increased. And it increased the damage to arterial blood vessels. It was important to give timely diagnosis and treatment.