睡眠呼吸暂停相关性高血压患者的临床分析  

Clinical analysis of obstructive sleep apnea-hypopnea syndrome-related hypertensive patients

作　　者：韩瑞梅[1] 李南方[1] 严治涛[1] 汪迎春[1] 张丽丽[1] 程维平[1] 毕云伟[1] 王新玲[1] 欧阳玮进[1] 

机构地区：[1]新疆维吾尔自治区人民医院高血压中心,新疆高血压研究所,乌鲁木齐830001

出　　处：《中华高血压杂志》2011年第11期1070-1074,共5页Chinese Journal of Hypertension

基　　金：国家重点基础研究发展计划(973计划)项目(2012CB517802)

摘　　要：目的分析睡眠呼吸暂停相关性高血压患者的临床特点、性别与年龄分布及其合并症情况。方法采用回顾性研究方法,分析2004-01-2010-03收住新疆自治区人民医院高血压科的高血压患者1976例的临床资料,根据多导睡眠仪监测结果分为单纯高血压患者386例为Ⅰ组,高血压合并轻度阻塞性睡眠呼吸暂停综合征(OSAHS)患者581例为Ⅱ组,高血压合并中度OSAHS患者458例为Ⅲ组,高血压合并重度OSAHS患者551例为Ⅳ组,对4组患者的临床特点、性别、年龄分布及其合并症情况分析。结果与Ⅳ组比较,Ⅰ组、Ⅱ组和Ⅲ组腰围[(95.1±9.5)、(98.5±9.3)、(100.1±8.7)比(103.5±9.8)cm]、体质量指数[(26.8±3.0)、(27.6±3.2)、(28.8±3.4)比(29.3±3.4)kg/m2]、收缩压[(143.1±18.3)、(142.6±18.0)、(142.9±17.7)比(145.8±18.6)mmHg]、舒张压[(94.7±12.5)、(93.7±11.4)、(94.1±11.6)比(96.9±12.9)mmHg]较低(均P<0.05);1976例患者中,男性OSAHS相关性高血压患者检出率为83.3%(1239/1487),女性检出率为71.8%(351/489),差异有统计学意义(χ2=31.139,P<0.01),60～70岁住院的男性和女性高血压患者检出率最高,分别达94.7%、90.8%。青年、中年及老年人的构成比分别为39.8%、46.3%和13.8%,超重和肥胖者比例达92.4%。与Ⅳ组比较,Ⅰ、Ⅱ、Ⅲ组冠状动脉性心脏病、脑血管病和脂肪肝检出率较低(P<0.01)。结论睡眠呼吸暂停相关性高血压患者以中年男性、肥胖者为多,60～70岁年龄段检出率较高,尤其重度组合并有多种心脑血管疾病,临床危害较大。Objective To analyze the clinical characteristics, age and sex distribution, and complications of obstructive sleep apnea-hypopnea syndrome-related hypertensive patients. Methods Retrospective study was performed in 1976 hypertensive patients at department of hypertension in People＇s Hospital of Xiniiang Uygur .Autonomous Region from January 2004 to March 2010, which were divided into four groups by the results of polysomnography： hypertension without obstructive sleep apnea-hypopnea syndrome （OSAHS） （group Ⅰ ,n= 386）, hypertension with mild OSAHS （group Ⅱ , n=581） , hypertension with moderate OSAHS （group Ⅲ, n=458） and hypertension with severe OSAHS （group Ⅳ, n= 551）. The clinical characteristics, age and sex distribution, and complications were analyzed among the groups. Results Compared with group Ⅳ , patients in other three groups showed lower values of waist ebcumference[（95.1±9.5）, （98.5±9.3）,（100.1±8.7）vs （103.5±9.8） cm], body mass index[（26.8±3.0},（27.6±3.2） ,（28.8±3.4}vs （29.3±3.4）kg/m^2], systolic blood pressure[（143.1±18.3）,（142.6±18.0）, （142.9±17.7 ）.vs （ 145.8±18.6 ）mm Hg] and diastolic blood pressure[（94.7±12.5）, （ 93.7±11.4 ）, （94.1±11.6 ） vs（96.9±12.9）mm Hg] （all P〈0.05）. The detection rate of OSAHS-related hypertensive patients in male was higher than that in female among 1976 subjects{83.3%（1239/1487）vs 71.8%（351/489）, X^2 =31.139, P〈0.01）]. The detection rate of inpatients with hypertension aged between 60 and 70 years was the highest （in male 94.7% and in female 94.7% ）. The proportion of the young, middle-aged and elderly was 39.8%, 46.3% and 13.8%, respectively. The prevalence of overweight and obesity in this cohort was 92.4%. The detective rates of coronary heart disease, cerebral disease and adiposis hepatica in group Ⅰ , Ⅱ and Ⅲ were lower compared with those in group Ⅳ （P〈0.01）. Conclusions Middle-aged men and obese individuals constitute the

关 键 词：高血压 阻塞性睡眠呼吸暂停综合征 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]