持续气道正压治疗对阻塞性睡眠呼吸暂停低通气综合征患者晨间血压升高的影响  

Effect of Continuous Positive Airway Pressure Treatment on the Rise of Morning Blood Pressure in the Patients with Obstructive Sleep Apnea and Hypopnea Syndrome

作　　者：刘松[1] 刘立[2] 张宁[2] 李萍[2] 许玲华[2] 贺正一[1] 

机构地区：[1]首都医科大学附属北京友谊医院呼吸内科 [2]江苏省徐州市中心医院呼吸内科

出　　处：《首都医科大学学报》2008年第5期632-635,共4页Journal of Capital Medical University

摘　　要：目的研究持续气道正压(CPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者晨间血压升高的影响。方法经多导睡眠图(PSG)确诊并具有晨间血压升高的OSAHS患者105例为研究对象。其中进行CPAP治疗的49例为CPAP治疗组,未针对OSAHS治疗的56例为对照组。记录PSG的监测结果,测定晚间和晨间左上肢血压。晨间收缩压大于等于晚间收缩压10mmHg,或(和)晨间舒张压大于等于晚间舒张压10mmHg者被认为有晨间血压升高。治疗4～5周后再次进行PSG监测并且测量晚间晨间血压,比较PSG监测结果和晨间血压升高情况。结果治疗前CPAP治疗组和对照组的临床资料、晨间血压值和PSG监测结果差异无统计学意义;CPAP治疗组患者治疗后晨间血压数值明显降低(P<0.05),晨间血压升高的例数明显减少(P<0.01),PSG监测多项指标明显好转(P值均<0.01);对照组患者前后两次记录的晨间血压数值、晨间血压升高的例数和PSG监测结果差异均无统计学意义。结论CPAP治疗在改善OSAHS患者病情的同时,能够显著改善OSAHS患者的晨间血压升高。Objective To investigate the effect of continuous positive airway pressure （CPAP） treatment on the rise of morning blood pressure in the patients with obstructive sleep apnea and hypopnea syndrome （OSAHS）. Methods 105 patients with OSAHS diagnosed by polysomnography（PSG） were enrolled the study. 49 patients were treated with CPAP（ CPAP group, and the other patients （56 cases） were treated without CPAP （control）. The clinical characteristics and PSG data of all patients were documented, which included age, body height, body weight, neck circumference, abdominal circumference, the family history of hypertension, respiratory disturbance index（RDI）, the minimum oxygen saturation（ SpO2 ） during sleep, percentage of recording time with oxygen saturation of 90% or less（ SAT 〈 90 ）, and the longest apnea time. Blood pressure （BP） was recorded in the evening before the sleep and wakefulness from sleep. The definition of morning BP rise is that the patient＇ s morning systolic BP（SBP） or diastolic BP（DBP） was 10 mmHg higher than that of the evening SBP or DBP respectively. The above data of CPAP group were compared with that of the control. After 4 ~ 5 weeks＇ treatment, the above data before and after the treatment were compared and analyzed in CPAP and controls, respectively~ Results There is no significant difference between the CPAP and control in clinical information, the morning blood pressure and the PSG results （ P 〉 0.05 ） before the treatment. After the CPAP treatment, the morning blood pressure decreased, the percentage of the patients with the rise of morning blood pressure reduced, and the PSG parameters changed for the better in the CPAP group （ P 〈 0.05 ）. However, the above parameters after the treatment show no significant difference compared with that before the treatment in control （ P 〉 0. 05, respectively）. Conclusion CPAP treatment can lower morning BP, and improve PSG parameters in patients with OSAHS.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 血压 持续气道正压治疗 

分 类 号：R338.63[医药卫生—人体生理学]