原发性高血压患者血压节律与睡眠结构相关性的研究

Study of relationship between circadian rhythm and sleep architecture of patients with essential hypertension

目的探讨原发性高血压患者血压节律与睡眠结构的关系及其机制。方法选取中日友好医院2015年1月至2017年9月收治的原发性高血压患者117例,根据血压节律进行分组,分为正常节律组(杓型,30例)和非正常节律组(包括非杓型、反杓型,共87例),分别对2组患者行动态血压监测和心肺耦合监测,然后对其动态血压监测结果、睡眠结构和心率变异性进行统计分析。结果非正常节律组患者的总睡眠时间显著低于正常节律组(P <0.05),深睡比例显著高于正常节律组(P <0.05),但2组患者的初入深睡时间、深睡比例、梦/醒比例的差异均无统计学意义(P> 0.05)。2组患者的心率变异性差异有统计学意义。结论原发性高血压患者血压节律与睡眠结构显著相关,总睡眠时间减少、深睡比例下降可能与异常的血压节律相关,其机制可能与自主神经功能异常有关。

Objective To study relationship and mechanism between the circadian rhythm and sleep architecture of patients with essential hypertension. Methods One hundred and seventeen cases of patients with essential hypertension treated in China-Japan Friendship Hospital were selected, and were divided into normal rhythm group（dipper type, 30 cases）, abnormal rhythm group （including non-dipper and anti-dipper types, 87 cases） according to blood pressure rhythm.The two groups were given ambulatory blood pressure monitoring and cardiopulmonary coupling monitoring. And the sleep architecture and heart rate variability were statistically analyzed. Results The total sleep time of the abnormal rhythm group was significantly lower than that of the normal rhythm group （P〈0.05）, the proportion of deep sleep time of the abnormal rhythm group was significantly lower than the normal rhythm group （P〈0.05）, but the differences of light sleep time and the dream/waking between the two groups were not significant （P〉0.05）. The heart rate variability between two groups had significant differences. Conclusion Circadian rhythm is significantly associated with sleep architecture of patients with essential hypertension, less sleep time and lower proportion of deep sleep may be related to abnormal blood pressure rhythm, and its mechanism may be related to abnormal autonomic nervous function.