阻塞型睡眠呼吸暂停综合征相关性高血压与快速眼动睡眠期参数的关系

Correlation between Obstructive Sleep Apnea Hypopnea Syndrome Related Hypertension and Rapid Eye Movement Sleep Period Indexes

目的分析阻塞型睡眠呼吸暂停综合征(OSAHS)相关性高血压与快速眼动(REM)睡眠期参数的关系。方法选取2015年8月至2019年5月在黄山市人民医院完成多导睡眠图监测的279例成人OSAHS患者作为研究对象,根据是否合并高血压分为高血压组(97例)和非高血压组(182例)。比较两组患者的REM参数[呼吸暂停低通气指数(AHI)、总睡眠时间(TST)、REM时间、REM睡眠潜伏期、每小时呼吸相关微觉醒次数、平均脉搏血氧饱和度(MSpO_(2))、最长呼吸暂停时间(LAT)、最低动脉血氧饱和度(LSaO_(2))]。采用多因素Logistic回归模型分析REM参数对OSAHS相关性高血压的影响,并采用Spearman相关分析LSaO_(2)与各临床参数的关系。结果高血压组的AHI、LAT均多于非高血压组[57(33,74)次比41(20,65)次,58(42,79)s比52(34,70)s],REM时间短于非高血压组[(68±37)min比(81±41)min],MSpO_(2)低于非高血压组[0.93(0.91,0.95)比0.94(0.93,0.96)](P<0.05或P<0.01)。多因素Logistic回归分析显示,REM时间缩短为OSAHS患者发生高血压的独立危险因素(P<0.05)。Spearman相关性分析结果显示,LSaO_(2)与BMI、AHI、TST、LAT分别呈负相关(r=-0.467,P<0.001;r=-0.732,P<0.001;r=-0.166,P=0.006;r=-0.692,P<0.001);与年龄、REM时间、REM睡眠潜伏期、每小时呼吸相关微觉醒次数无明显相关性(r=-0.015,P=0.809;r=0.070,P=0.247;r=0.033,P=0.585;r=0.050,P=0.404)。结论OSAHS相关性高血压患者REM睡眠时间缩短,MSpO_(2)降低,同时AHI、LAT增加。

Objective To analyze the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)related hypertension and rapid eye movement(REM)sleep period indexes.Methods A total of 279 people who completed polysomnography monitoring in Huangshan City People′s Hospital from Aug.2015 to May 2019 were included as the research objects.They were divided into a hypertension group(97 cases)and a non-hypertension group(182 cases)according to whether they were complicated with hypertension.The REM indexes[apnea hypopnea index(AHI),total sleeping time(TST),REM time,REM sleep latency,respiratory related micro awakening times per hour,mean pulse oxygen saturation(MSpO_(2)),longest apnea time(LAT),and lowest arterial oxygen saturation(LSaO_(2))]were compared between the two groups.Multivariate Logistic regression model was used to analyze the effect of REM indexes on OSAHS related hypertension,and Spearman correlation was used to analyze the relationship between LSaO_(2) and different clinical parameters.Results AHI and LAT in the hypertension group were higher than those in the non-hypertension group[57(33,74)vs 41(20,65),58(42,79)s vs 52(34,70)s],REM time was shorter than that in the non-hypertension group[(68±37)min vs(81±41)min],and MSpO_(2) was lower than that in the non-hypertension group[0.93(0.91,0.95)vs 0.94(0.93,0.96)](P<0.05 or P<0.01).Multivariate Logistic regression analysis showed that the shortening of REM time was an independent risk factor for hypertension in OSAHS patients(P<0.05).Spearman correlation analysis showed that LSaO_(2) was negatively correlated with BMI,AHI,TST and LAT(r=-0.467,P<0.001;r=-0.732,P<0.001;r=-0.166,P=0.006;r=-0.692,P<0.001);it had no significant correlation with age,REM time,REM sleep latency and respiratory related micro awakening times per hour(r=-0.015,P=0.809;r=0.070,P=0.247;r=0.033,P=0.585;r=0.050,P=0.404).Conclusion In patients with OSAHS related hypertension,REM sleep time is shortened,MSpO_(2) decreases,and AHI and LAT increase.