高血压合并阻塞性睡眠呼吸暂停低通气综合征患者的临床特点及血液流变学指标变化分析

Clinical Characteristics and Changes of Hemorheology in Patients with Hypertension Complicated with Obstructive Sleep Apnea Hyponea Syndrome

目的:研究高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床特点及血液流变学指标变化情况。方法:选取2020年11月—2021年10月贵州医科大学附属医院收治的90例高血压合并OSAHS患者作为研究对象,依照患者OSAHS病情程度分为轻度组、中度组、重度组,各30例。另选取同期30例健康体检者为对照组。四组均行多导睡眠仪监测及血液流变学检测,比较四组检测结果差异,对高血压合并OSAHS患者血液流变学检测结果与多导睡眠监测结果的相关性进行分析。结果:轻度组、中度组和重度组的呼吸暂停低通气参数、血氧饱和度<90%时间比例高于对照组,最长呼吸暂停时间长于对照组,最低血氧饱和度低于对照组,差异有统计学意义(P<0.05)。对照组血细胞比容、血浆黏度、全血高切黏度、全血中切黏度、全血低切黏度、红细胞聚集指数均优于轻度组、中度组、重度组,差异有统计学意义(P<0.05)。Pearson相关系数分析显示,高血压合并OSAHS患者的血细胞比容、全血高切黏度、全血中切黏度、全血低切黏度、红细胞聚集指数与呼吸暂停低通气参数、血氧饱和度<90%时间比例、最长呼吸暂停时间呈正相关(P<0.05),与最低血氧饱和度呈负相关(P<0.05)。结论:高血压合并OSAHS患者存在显著的睡眠紊乱症状,同时各项血液流变学指标相较健康群体亦有显著升高,患者OSAHS病情越严重的情况下血液流变学指标水平越高,血液流变学指标异常与其睡眠紊乱症状相关。

Objective:To study the clinical characteristics and changes of hemorheology in patients with hypertension complicated with obstructive sleep apnea hyponea syndrome(OSAHS).Method:A total of 90 patients with hypertension complicated with OSAHS admitted to the Affiliated Hospital of Guizhou Medical University from November 2020 to October 2021 were selected as the study objects,and they were divided into mild group,moderate group and severe group according to the degree of OSAHS,with 30 cases in each group.Another 30 healthy subjects in the same period were selected as control group.The four groups were all monitored by polysomnography and hemorheology.The difference of detection results among the four groups were compared,and the correlation between hemorheology detection results and polysomnography monitoring results in patients with hypertension complicated with OSAHS were analyzed.Result:The apnea hypopnea parameters,the proportion of blood oxygen saturation<90%of the mild group,moderate group and severe group were higher than those of the control group,the longest apnea time was longer than that of the control group,and the lowest blood oxygen saturation was lower than that of the control group,and the differences were statistically significant(P<0.05).The hematocrit,plasma viscosity,whole blood high tangential viscosity,whole blood middle tangential viscosity,whole blood low tangential viscosity and red blood cell aggregation index in control group were better than those in mild group,moderate group and severe group,the differences were statistically significant(P<0.05).Pearson correlation coefficient analysis showed that hematocrit,whole blood high tangential viscosity,whole blood middle tangential viscosity,whole blood low tangential viscosity,red blood cell aggregation index were positively correlated with apnea hypopnea parameters,the proportion of blood oxygen saturation<90%,the longest apnea time in patients with hypertension complicated with OSAHS(P<0.05);and it was negatively correlated with the lowest blood oxygen saturation(P<0.05).Conclusion:Patients with hypertension combined with OSAHS have significant symptoms of sleep disorders,and all hemorheology indexes are also significantly higher than those in healthy groups.The more severe the condition of OSAHS,the higher the level of hemorheology indexes,and the abnormal hemorheology indexes are closely related to the symptoms of sleep disorders.