青年人群阻塞性睡眠呼吸暂停低通气综合征和原发性高血压的关系

Relationship between Obstructive Sleep Apnea Hypopnea Syndrome and Primary Hypertension in Young Adults

目的:探讨青年人群阻塞性睡眠呼吸暂停低通气综合征(OSAHS)和原发性高血压的关系。方法:选取2017年8月-2018年12月本院收治的105例OSAHS青年患者。按呼吸暂停低通气指数(AHI)将其分为轻度组(AHI 5～20次)、中度组(AHI 21～50次)、重度组(AHI>50次),各35例,另选取同期健康成年人30例作为对照组,四组均行动态血压、睡眠监测,对中、重度患者行无创呼吸机治疗。比较四组血压、睡眠监测指标(AHI、BMI、MSaO_2、LSaO_2),比较OSAHS有无合并原发性高血压患者的睡眠监测指标,比较中、重度患者治疗前后的血压。结果:重度组BMI、AHI、收缩压、舒张压均高于其他三组,MSaO_2、LSaO_2均低于其他三组,比较差异均有统计学意义(P<0.05);合并原发性高血压者BMI、AHI均高于未合并原发性高血压者,MSaO_2、LSaO_2均低于未合并原发性高血压者,比较差异均有统计学意义(P<0.05);中、重度组治疗后收缩压、舒张压均低于治疗前(P<0.05)。结论:OSAHS是引发或加重原发性高血压的主要原因,临床应重视OSAHS青年人群,叮嘱患者戒烟忌酒、降低血管紧张素活性,预防心血管疾病发生。

Objective:To evaluate the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)and primary hypertension in young people.Method:A total of 105 young patients with OSAHS from August 2017 to December 2018 in our hospital were selected.According to the apnea hypopnea index(AHI),they were divided into mild group(AHI 5-20 times),moderate group(AHI 21-50 times)and severe group(AHI>50times),35 cases in each group.30 healthy adults in the same period were selected as control group.Four groups were monitored by ambulatory blood pressure and sleep,and non-invasive ventilator treatment was given to moderate and severe patients.The blood pressure and sleep monitoring indicators(AHI,BMI,MSaO2,LSaO2)in four groups were compared,the sleep monitoring indicators of OSAHS patients with or without essential hypertension were compared,and blood pressure of moderate and severe patients before and after treatment was compared.Result:The BMI,AHI,systolic blood pressure and diastolic blood pressure in severe group were higher than those of other three groups,MSaO2 and LSaO2 were lower than those of other three groups,the differences were statistically significant(P<0.05).The BMI and AHI in OSAHS patients with essential hypertension were higher than those of without essential hypertension,MSaO2 and LSaO2 were lower than those of without essential hypertension(P<0.05).The systolic blood pressure and diastolic blood pressure in moderate and severe groups after treatment were lower than those of before treatment(P<0.05).Conclusion:OSAHS is the main cause of causing or aggravating essential hypertension.Clinical attention should be paid to the young people of OSAHS,warning patients to quit smoking and abstain from alcohol,reduce angiotensin activity,and prevent cardiovascular disease.