持续正压通气对高血压合并阻塞性睡眠呼吸暂停患者血压昼夜节律的影响

Effects of continuous positive pressure ventilation on blood pressure circadian rhythm in hypertensive patients with obstructive sleep apnea

目的：探讨持续正压通气对高血压（HP）合并阻塞性睡眠呼吸暂停（OSA）患者血压昼夜节律的影响。方法选取2013年5月至2015年10月 HP 合并 OSA 患者70例，所有患者均给予持续正压通气（CPAP）治疗，对比分析患者治疗前后血压昼夜节律的变化。结果治疗前患者的夜间平均舒张压（nDBP）、夜间平均收缩压（nSBP）、白天平均收缩压（dSBP）、白天平均舒张压（dDBP）、24 h 平均收缩压（24 h SBP）、24 h 平均舒张压（24 h DBP）均明显高于治疗后，差异有统计学意义（P ﹤0.05）；患者治疗后的最低动脉血氧饱和度（SaO2）、平均 SaO2较治疗前明显升高，但呼吸暂停低通气指数（AHI）较治疗前明显降低，差异有统计学意义（P ﹤0.05）。结论 CPAP治疗 HP 合并 OSA 患者的临床效果较好，可显著改善患者的睡眠质量，促使患者血压昼夜节律异常恢复正常，提高患者的生存质量，且操作安全、简便，值得临床上广泛应用。

Objective To investigate the effect of continuous positive pressure ventilation on the circadian rhythm of blood pressure in patients with hypertension（ HP）and obstructive sleep apnea （OSA）. Methods Seventy HP patients with OSA from May 2013 to October 2015 were treated by con-tinuous positive airway pressure（CPAP）. The changes of blood pressure and circadian rhythm of blood pressure before and after treatment were compared. Results The dSBP,dDBP,24 h SBP,24 h DBP and nSBP,nDBP before treatment were significantly higher than those after treatment,the differences were significant（P ﹤ 0. 05）;After treatment,the lowest SaO2 and the average SaO2 increased signifi-cantly than before treatment,but the level of AHI was lower than that before treatment,the differences were significant（P ﹤ 0. 05）. Conclusions The clinical effect of CPAP on HP patients with OSA is bet-ter,and it can significantly improve the patient’s sleep quality,make the blood pressure circadian rhythm abnormalities returned to normal,and improve the quality of life of patients,and safe and conven-ient operation,it is worth widely applied in clinic.