持续气道正压通气对阻塞性睡眠呼吸暂停低通气综合征患者难治性高血压的影响

Effect of the continuous positive airway pressure on refractory hypertension in patients with obstructive sleep apnea hypopnea syndrome

目的研究在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并难治性高血压(resistant hypertension,RH)患者中,持续气道正压通气(CPAP)治疗对血压控制的影响。方法 55例OSAHS合并RH患者行CPAP治疗,治疗前及治疗后6个月行动态血压监测,观察血压控制情况。结果治疗后,所有患者血压均有不同程度下降,治疗前全天平均收缩压及舒张压为(136.4±2.8)mmHg及(85.6±1.7)mmHg,治疗后分别降至(126.9±1.0)mmHg及(76.8±1.3)mmHg,差异均有统计学意义(t_(收缩压)=24.409,t_(舒张压)=32.688,P均<0.05);收缩压下降均值(9.6±3.0)mmHg,舒张压下降均值(8.7±2.0)mmHg,收缩压及舒张压下降值与呼吸暂停低通气指数相关(r_(收缩压)=0.893,r_(舒张压)=0.854)。31例服用降压药物种类减少。结论 CPAP治疗能有效改善OSAHS合并RH患者的血压水平,减少降压药物的使用。

OBJECTIVE To invest igate the effect of continuous positive airway pressure（CPAP） on blood pressure in patients with obstructive sleep apnea hypopnea syndrome（OSAHS） and refractory hypertension. METHODS Fifty five OSAHS patients with refractory hypertension were treated with CPAP. Ambulatory blood pressure monitoring was performed to the patients before and 6 months after the treatment. RESULTS After treatment, the blood pressure of all the patients decreased at different degrees. The mean of 24 h systolic blood pressure（SBP） and 24 h diastolic blood pressure（DBP） decreased from （136.4±2.8）mmHg and （85.6±1.7）mmHg to （126.9±1.0）mmHg and （76.8±1.3）mmHg, the differences were statistically significant （P 0.05）.The mean decrease of 24 h SBP and DBP were （9.6±3.0）mmHg and （8.7±2.0）mmHg. The decrease value of 24 h SBP and DBP were concerned with apnea and hypopnea index. The numbers of antihypertensive drugs decreased in 31 patients. CONCLUSION After CPAP treatment, the blood pressure of the patients with OSAHS and refractory hypertension dropped significantly, and the varieties of antihypertensive drugs taken in these patients were reduced significantly.