OSAHS对原发性高血压患者血压、心率及心功能的影响

Effect of obstructive sleep apnea hypopnea syndrome on blood pressures,heart rates and cardiac function in patients with essential hypertension

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对原发性高血压(EH)患者血压(BP)及心率(HR)和心功能的影响。方法选取该院收治的EH患者100例,其中52例合并OSAHS,单纯EH为48例,分别设为EH合并OSAHS组、单纯EH组,另选取体检合格健康人员50例为对照组。3组均进行多导睡眠监测(PSG)、24h动态血压监测(ABPM)及心电图监测(Holter),观察3组BP、HR及舒张末期间隔厚度(IVST)、舒张末左室内径(LVIDd)、左心室质量(LVMI)指标变化。结果 3组平均24hHR、白昼平均心率(DHR)比较差异无统计学意义(P>0.05);EH合并OSAHS组、单纯EH组夜间平均心率(NHR)显著低于对照组,且EH合并OSAHS组显著低于单纯EH组,差异均有统计学意义(P<0.05);EH合并OSAHS组、单纯EH组昼、夜平均收缩压(SBP)与舒张压(DBP)平均值均显著高于对照组(P<0.05),且EH合并OSAHS组显著高于单纯EH组,差异均有统计学意义(P<0.05);EH合并OSAHS组、单纯EH组IVST、LVIDd、LVMI均显著高于对照组,且EH合并OSAHS组显著高于单纯EH组,差异均有统计学意义(P<0.05)。结论 OSAHS可引起EH患者BP升高,夜间HR降低,诱发心功能指标升高。

Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome（OSAHS）on blood pressures（BP）,heart rates（HR）and cardiac function in the patients with essential hypertension（EH）.Methods One hundred cases of EH treated in our hospital were selected,including 50 cases of EH complicating OSAHS and 48 cases of simple EH,and assigned as the EH complicating OSAHS group and simple EH group.Other 50 qualified persons of physical examination were selected as the control group.The three groups were performed the multi-conduction sleep monitoring（PSG）,24 hours ambulatory blood pressure monitoring（ABPM）and ECG monitoring（Holter）.The changes of BP,HR and IVST,LVIDd and LVMI indexes were observed in the three groups.Results The mean 24 hours HR and DHR had no statistical difference among the three groups（P〉0.05）.The mean NHR in the EH complicating OSAHS group and simple EH group was significantly lower than that in the control group,moreover EH complicating OSAHS group was significantly lower than the simple EH group,the differences were statistically significant（P〈0.05）;the mean daytime and night SBP and DBP in the EH complicating OSAHS group and simple EH group were significantly higher than those in the simple EH group（P〈0.05）,moreover the EH complicating OSAHS group was significantly higher than the simple EH group,the difference was statistically significant（P〈0.05）;IVST,LVIDd and LVMI in the EH complicating OSAHS group and simple EH group were significantly higher than those in the control group（P〈0.05）,moreover the EH complicating OSAHS group was significantly higher than the simple EH group with statistical difference（P〈0.05）.Conclusion OSAHS can cause the BP increase and the HR decrease at night in the patients with EH,which can induce the cardiac function index increase.