持续正压通气对阻塞性睡眠呼吸暂停合并难治性高血压患者血压影响的Meta分析

Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea:A meta-analysis

目的:系统性评价持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSA)合并难治性高血压患者血压的影响。方法:计算机检索Cochrane Library、PubMed、ScienceDirect、Web of Science等数据库并手工检索相关期刊,查找CPAP治疗对OSA合并难治性高血压患者血压影响的临床随机对照试验(RCT),对符合条件的RCT,逐一评价质量,提取资料,采用RevMan5.3和R 3.2.2软件进行Meta分析。结果:共纳入7篇RCT研究。Meta分析结果显示:CPAP治疗后,患者24h平均收缩压/舒张压较对照组有显著改善(P<0.05)。24h平均收缩压/舒张压合并效应统计结果为:[WMD=-5.36,95%CI:(-8.60,-2.11),P=0.001;I^2=70%]/[WMD=-4.21,95%CI:(-6.39,-2.04),P=0.000 01;I^2=79%]。结论:CPAP治疗可有效地降低OSA合并难治性高血压患者的血压。

Objective：To systematically evaluate the impact of continuous positive airway pressure（CPAP）on blood pressure in patients with resistant hypertension and obstructive sleep apnea（OSA）.Method：The related RCT literature of CPAP on blood pressure in patients with resistant hypertension and OSA had been searched from Cochrane Library,PubMed,ScienceDirect,Web of Science,and the relevant journals had been retrieved manually.The clinic randomized controlled trials（RCT）of the treatment effect to resistant hypertension and OSA by CPAP were scanned.RCTs conformed to the condition were extracted to the quality of research and to be extracted in literature.The RevMan5.3and R3.2.2software was applied to carry out Meta-analysis.Result：Seven studies of RCTs are included.Meta-analysis showed that CPAP treatment significantly improved the 24-hour average systolic/diastolic blood pressure compared with the control group（P〈0.05）,the pooled estimates of mean change for 24-hour ambulatory mean systolic blood pressure and mean diastolic blood pressure were[WMD=-5.36,95%CI：（-8.60,-2.11）,P=0.001;I^2=70%]and [WMD=-4.21,95%CI：（-6.39,-2.04）,P=0.000 01;I^2=79%]respectively.Conclusion：CPAP therapy can significantly reduce blood pressure in patients with resistant hypertension and OSA.