高龄高血压合并阻塞性睡眠呼吸暂停低通气综合征患者的血压及血压变异性分析

Analysis of blood pressure and blood pressure variability in very elderly hypertensive patients with obstructive sleep apnea hypopnea syndrome

目的探讨高龄高血压合并阻塞性睡眠呼吸暂停低通气综合征（0sAHs）患者的血压及血压变异性特点。方法选择2012年8月至2015年6月就诊于我院的高龄高血压患者172例（其中男性111例、女性61例）。进行多导睡眠监测检查，根据呼吸暂停低通气指数（AHI）分为4组：非OSAHS组（对照组，38例）、轻度OSAHS组（A组，46例）、中度OSAHS组（B组，48例）和重度OSAHS组（c组，40例），比较四组患者临床特征、生化指标、血压、血压变异性的差异，分析血压、血压变异性与AHI的相关性。结果①四组患者的24h平均收缩压、24h平均舒张压、白天平均收缩压、白天平均舒张压、夜间平均收缩压、夜间平均舒张压随AHI的增加而明显升高，差异均有统计学意义（P均〈0．05）；Pearson相关分析显示，血压与AHI呈正相关（r分别=0．353，0．365，0．308，0．326，0．401，0．426）。②四组患者的24h收缩压变异性、24h舒张压变异性、白天收缩压变异性、白天舒张压变异性、夜间收缩压变异性、夜间舒张压变异性随AHI的增加而明显增大，差异均有统计学意义（JP均〈0．05）；Pearson相关分析显示，血压变异性与AHI呈正相关（r分别=0．402，0．429，0．338，0．371，0．469，0．533）。结论高龄高血压合并OSASH患者血压及血压变异性升高。

Objective To explore the characteristics of blood pressure and blood pressure variability in very elderly hypertensive patients with Obstructive Sleep Apnea Hypopnea Syndrome （OSAHS）. Methods A total of 172 very elderly hypertensive patients in our department from August 2012 to June 2015 （male 111 cases, fe- male 61 cases） were selected and checked polysomnography. According apnea-hypopnea index （AHI）, they were divided into four groups： Non-OSAHS group（Control group 38 cases） and mild OSAHS group（group A, 46 cas- es）, moderate OSAHS group（Group B, 48 cases） and severe OSAHS group（group C, 40 cases）. The differences of their clinical features, biochemical index, blood pressure and blood pressure variability were compared. The relationship between blood pressure, blood pressure variability and AHI were analyzed. Results （1）24-hour average systolic blood pressure, 24-hour average diastolic blood pressure, daytime average systolic blood pressure, daytime average diastolic blood pressure, nighttime average systolic blood pressure, nighttime average diastolic blood pres- sure of the four groups were significantly raised as AHI increased. The differences were statistically significant （P〈 0.05）. Pearson correlation analysis showed a positive correlation between blood pressure and AHI （r = 0.353,0.365,0.308,0.326,0.401,0.426）. （2）24-hour systolic blood pressure variability, 24-hour diastolic blood pressure variability, daytime systolic blood pressure variability, daytime diastolic blood pressure variability, nighttime systolic blood pressure variability, nighttime diastolic blood pressure variability of the four groups were signifi- candy raised as AHI increased. The differences were statistically significant （P〈0.05）. Pearson correlation analysis showed a positive correlation between blood pressure variability and AHI （r=0.402, 0.429, 0.338, 0.371, 0.469, 0.533）. Conclusion Maybe OSASH is another important factor to increase blood pressure and blood pressure variability of the very elderly hypertensive patients.