社区空巢高血压老人的睡眠状况与动态血压相关性分析

Analysis of Correlation Between Sleep Status and Ambulatory Blood Pressure in Empty Nest Elderly withHypertension in Community

目的:分析上海市城区某街道空巢高血压老人的睡眠状况与动态血压相关性,优化社区空巢高血压老人管理质量。方法:采用整群随机抽样法收集2020年1月上海市虹口区某街道辖区内社区公共卫生管理平台中在册管理的空巢高血压老人100例。收集老人24 h动态血压监测(ABPM)和匹兹堡睡眠质量指数量表(PSQI)的调查结果,分析动态血压与睡眠相关因素。结果:PQSI总分为(8.76±4.25)分,其中睡眠质量及睡眠时间得分在7个维度中较高,催眠药物得分在7个维度中最低。ABPM检查中,24 h平均收缩压(SBP)、夜间平均SBP高于参考值,SBP夜间下降不明显,DBP夜间未下降反上升。24 h平均SBP,日间平均DBP,夜间平均SBP、DBP与睡眠质量呈正相关,差异有统计学意义(P<0.05)。结论:辖区空巢高血压老人睡眠质量不佳,部分空巢高血压老人ABPM不达标,血压昼夜节律异常;睡眠质量与空巢高血压老人的动态血压呈正相关。

Objective:To analyze the correlation between sleep status and ambulatory blood pressure of empty nest elderly patients with hypertension in a street of Shanghai,and optimize the management quality of empty nest elderly patients with hypertension in the community.Methods:Using a cluster random sampling method,100 empty nest elderly patients with hypertension registered and managed in the community public health management platform of a street area of Shanghai Hongkou District were collected in January 2020.The 24 h ambulatory blood pressure monitoring(ABPM)and Pittsburgh Sleep Quality Index(PSQI)survey results of elderly patients were collected.The ambulatory blood pressure and sleep related factors were analyzed.Results:The total score of PQSI was(8.76±4.25)points,the scores of sleep quality and sleep time were higher in the seven dimensions,and the scores of hypnotic drugs were the lowest in the seven dimensions.In ABPM examination,the 24 h mean systolic blood pressure(SBP)and nighttime mean SBP were higher than the reference value,and the decline of nighttime SBP was not obvious,while nighttime DBP increased instead of decreased.The 24 h mean SBP,daytime mean DBP,nighttime mean SBP and nighttime mean DBP were positively correlated with sleep quality,and the difference was statistically significant(P<0.05).Conclusion:The sleep quality of empty nest elderly patients with hypertension is poor,the ABPM of part of empty nest elderly patients with hypertension does not meet the standard,and the circadian rhythm of blood pressure is abnormal;Sleep quality is positively correlated with ambulatory blood pressure in empty nest elderly patients with hypertension.