OSAHS伴血压异常患者经鼻Auto-CPAP治疗对血压改变情况的研究

A study of the blood pressure changes in OSAHS patients with hypertension by auto-CPAP treatment

目的:研究OSAHS伴高血压患者,经鼻auto-CPAP治疗对其血压改变的情况。资料与方法:30例OSAHS伴高血压患者,其中包括已确诊高血压患者9例(维持既往口服降压药物治疗方案不变)及本次研究新发现高血压患者21例(既往无口服常规降压药物,暂不给予口服药物治疗)。给予患者每晚有效auto-CPAP(RESmart GII,北京怡和嘉业医疗科技有限公司)连续治疗,分别于治疗前及治疗第1、2、4周复查24 h ABP,比较治疗前后患者血压改变情况。结果:1)30例患者auto-CPAP治疗1周后,24 h ABP各时段血压均较治疗前明显降低,24 h SBP/DBP降低5.73/3.43 mm Hg,d SBP/DBP降低5.40/3.53 mmHg,n SBP/DBP降低7.03/2.73 mm Hg。2)9例既往高血压患者与21例本次研究新发现高血压患者相比,1周治疗后仅n SBP及n DBP的变化有统计学意义。3)部分患者延长治疗至2、4周,仅治疗1周与2周d SBP的变化有统计学意义。结论:1)auto-CPAP治疗OSAHS有助于患者血压的控制与改善。2)OSAHS伴高血压患者经atuo-CPAP治疗(1、2、4周)后,血压的降低主要出现在第1周的治疗上,临床上建议以第1周auto-CPAP治疗结束后的24 h ABP数据作为参考,这对于OSAHS伴有高血压患者的药物干预或调整具有一定的临床意义。3)在auto-CPAP对OSAHS伴高血压患者的治疗中,既往口服降压药物比无口服降压药物患者的夜间血压下降幅度更大。

Objective： To study the changes of blood pressure in obstructive sleep apnea hypopnea syndrome （OS-AHS） patients with hypertension, and by the treatment of nasal automatic continuous positive airway pressure （ auto- CPAP） in patients with hypertension. Materials and methods ： 30 cases of hypertension patients, including 9 cases of patients with hypertension, previous oral antihypertensive drug regimens remain unchanged; this study newly discovered 21 hypertension patients. No previous oral antihypertensive drugs, temporarily given oral medication. The auto-CPAP （RESmart GII,BMC Medical Co.,Ltd. ） was given to patients per night and ensure that patients receive effective continuous treatment. Before treatment and after treatment 1, 2, 4 weeks after 24 hours dynamic state blood pressure （24 hABP） , compared with before and after treatment of patients with blood pressure changes. Results： 1） compared with 30 cases of OSAHS patients with hypertension by auto-CPAP treatment 1 week after, 24 hABP each time blood pressure compared with those before treatment were significantly lower, 24 hSBP/DBP is reduced about 5. 73/3. 43 mmHg, dSBP/DBP is reduced about 5. 40/3. 53 mmHg, nSBP/DBP is reduced about 7. 03/2. 73 mmHg. 2） 9 cases of hypertension patients compared with 21 cases of the new study found that patients with hypertension, after 1 week of treatment, changes to only the nSBP,nDBP have statistical significance. 3 ） In the observation period for 1,2,4 weeks after depressurization amplitude compared, only for 1 week and 2 weeks dSBP change was statistically significant. Conclusion： 1） Auto-CPAP treat-ment of OSAHS is helpful for the control and improvement of blood pressure. 2 ） After atuo-CPAP treatment （1 ,2 , 4 weeks）,the blood pressure of patients with hypertension reduction is mainly in the treatment of first weeks, the clinical recommendations to first weeks after the end of the 24 hABP data as a reference, which has a certain clinical significance for OSAHS patients with hypertension. 3 ） In the auto-CPAP in OSAHS patients with hypertension treatment, this study showed that with a history of oral antihypertensive drugs than those without oral antihypertensive drugs in patients with nocturnal blood pressure decreased substantially more.