阻塞性睡眠呼吸暂停低通气综合征合并高血压患者的多导睡眠图分析  

Analysis of polysomnography in patients with obstructive sleep apnea/hypopnea syndrome accompanied with hypertension

作　　者：王火[1] 殷兴艳[1] 武蔚[1] 刘斌[1] 

机构地区：[1]武警医学院附属医院呼吸科,天津300162

出　　处：《武警医学院学报》2006年第3期187-189,共3页Acta Academiae Medicinae CPAPF

基　　金：武警部队科研基金项目(WKH2002-19)

摘　　要：【目的】研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者的多导睡眠图表现,分析影响OSAHS合并高血压患者的昼夜血压的因素。【方法】OSAHS患者根据门诊血压、24 h动态血压和多导睡眠图监测结果分为OSAHS合并高血压组(OSAHS+HT组)30例与单纯OSAHS组30例。测定呼吸暂停低通气指数(AHI)、最低血氧饱和度(MinSaO2)、氧减饱和度指数(ODI)、觉醒指数(AI)及睡眠分期的变化。以OS-AHS+HT组24 h平均收缩压与舒张压分别与ODI做回归分析。【结果】OSAHS+HT组患者的AHI,ODI均高于单纯OSAHS组患者(P<0.01,P<0.05),OSAHS+HT组的浅睡眠(1期)明显高于OSASH组(P<0.05),深睡眠(3期+4期)明显低于OSAHS组(P<0.05)。氧减饱和度指数是影响OSAHS+HT组24 h平均收缩压与舒张压的重要因素(ASBP:r=0.302,P<0.05;ADBP:r=0.319,P<0.05)。【结论】(1)OS-AHS合并高血压患者较OSAHS组有明显的通气功能和睡眠结构紊乱;(2)低氧是影响OSAHS合并高血压患者昼夜血压水平的重要因素,它可能是参与OSAHS患者长期高血压形成的重要因素。[Objective] To study the polysomnography in patient with obstructive sleep apnea/hypopnea syndrome （OSAHS） accompanied with hypertension and to assess the factors which contribute to nocturnal and diurnal elevation of blood pressure in OSAHS patients with hypertension. [Methods] 30 OSAHS patients with hypertension and 30 OSAHS patients without hypertension were selected for study. The apnea/hypopnea index （AHI）, minimum oxygen saturation （ MinSaO2）, oxygen saturation decreased index （ODI）, sleep structure were analyzed in OSAHS patients with and without hypertension. 24 h average systolic and diastolic blood pressure （ASBP and ADBP） were measured. Regression analysis was performed to find the correlation between 24 h ASBP, ADBP and ODI in OSAHS patients with hypertension. [Results] 1. AHI and ODI of OSAHS with hypertension group were more significantly increased than that of the OSAHS group （ P 〈 0.01, P 〈 0.05）. The time percentages of stage 1 sleep in OSAHS with hypertension group were significantly increased （ P 〈 0.05）, but the time percentages of stage 3, 4 sleeps were significantly decreased （ P 〈 0.05 ）. 2. ODI was significantly affecting the 24 h ASBP and ADBP in OSAHS patients with hypertension （ASBP： r = 0.302, P 〈 0.05; ADBP： r = 0.319, P 〈 0.05）. [Conclusion] 1.The sleep structure the OSAHS with hypertension is more disturbed. 2. Hypoxia may he an important factor for circadian elevation of blood pressure in OSAHS patients with hypertension.It may contribute to the development of hypertension in patients with OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 高血压 低氧血症 

分 类 号：R563.8[医药卫生—呼吸系统]