老年阻塞性睡眠呼吸暂停低通气综合征相关高血压影响因素分析

Influencing factors of OSAHS-related hypertension in the elderly

目的探究老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)相关高血压的影响因素。方法入选经多导睡眠监测(PSG)诊断为OSAHS老年患者609例,按血压水平分为非高血压组174例和高血压组435例,比较2组PSG各指标的差异。采用Spearman相关性分析和多因素logistic回归分析。结果2组体质量指数(BMI)、呼吸暂停低通气指数(AHI)、血氧饱和度(SaO_2)<90%时间比较,差异有统计学意义(P<0.05,P<0.01)。年龄、BMI、最长暂停时间、SaO_2<90%时间、SaO_2<90%时间占总监测时间的百分比、TG、血糖、尿酸等与高血压呈正相关,HDL、总胆红素、平均SaO_2与高血压呈负相关(P<0.05,P<0.01)。logistic回归分析示,BMI、AHI、尿酸、糖尿病和总胆红素是OSAHS相关高血压的影响因素(OR=1.087、1.014、1.003、3.438和0.951,P<0.05,P<0.01)。年龄为女性相关高血压的影响因素(OR=1.103,P<0.05)。结论BMI、AHI、尿酸和糖尿病是老年OSAHS相关高血压的危险因素,总胆红素是其保护因素;增龄是此类女性患者的危险因素。

Objective To study the influencing factors of OSAHS-related hypertension in the elderly.Methods Six hundred and nine elderly OSAHS patients were divided into hypertension-free group(n=174)and hypertension group(n=435).The PSG indicators were compared and analyzed by Spearman correlation analysis and multivariate logistic regression analysis respectively.Results Significant differences were detected in BMI,AHI and SaO2<90%between the two groups(P<0.05,P<0.01).Age,BMI,SaO2<90%,SaO2<90%/total monitoring time ratio,serum TG,blood glucose and UA levels were positively related with hypertension while serum HDL and TB levels and mean SaO2 were negatively related with hypertension in elderly OSAHS patients(P<0.05,P<0.01).Logistic regression analysis showed that BMI,AHI,DM,serum UA and TB levels were the influencing factors of hypertension in elderly OSAHS patients(OR=1.087,OR=1.014,OR=1.003,OR=3.43,OR=0.951,P<0.05,P<0.01).Age was an influencing factor of hypertension in female OSAHS patients(OR=1.103,P<0.05).Conclusion BMI,AHI,DM and serum UA level are the risk factors for hypertension while serum TB level is a protective factor for hypertension in elderly OSAHS patients.Aging is a risk factor for hypertension in female OSAHS patients.