阻塞型睡眠呼吸暂停低通气综合征相关高血压的诊治进展

Progress in diagnosis and treatment of hypertension associated with obstructive sleep apnea-hypopnea syndrome

阻塞型睡眠呼吸暂停低通气综合征(OSAHS)与高血压的关系非常密切,目前研究认为OSAHS是继发性高血压中非常常见的原因,是难治性高血压的主要原因。OSAHS引起高血压的机制比较复杂,多种机制参与了高血压的发生,其中OSAHS患者睡眠紊乱可能是引起交感神经活性增强以及间歇性低氧的重要原因。OSAHS相关高血压的诊断主要依靠多导睡眠监测和血压的测量。持续气道正压治疗是OSAHS患者首选的治疗方法,对于OSAHS合并高血压的患者,在临床上也应当注意醛固酮拮抗剂、口腔矫正器以及呼吸肌肉训练的使用。

Obstructive sleep apnea-hypopnea syndrome(OSAHS)is closely associated with hypertension.Studies claim OSAHS as the most common cause of secondary hypertension and an important cause of refractory hypertension.The mechanism of hypertension caused by OSAHS is complex,and multiple mechanisms are involved in the occurrence of hypertension,among which the enhancement of sympathetic nerve activity and intermittent hypoxia(IH)in patients with OSAHS may be an important cause.The diagnosis of OSAHS-associated hypertension depends on polysomnography and blood pressure.Continuous positive airway pressure(CPAP)is the preferred treatment for OSAHS patients.In OSAHS patients with hypertension,aldosterone antagonists,mandibular advancement devices(MAD)and inspiratory muscle training(IMT)should be considered in clinical practice.