气道正压通气对阻塞性睡眠呼吸暂停综合征并高血压动态血压和呼吸睡眠监测的影响  

Effect of positive airway pressure on ambulatory blood pressure and respiratory polysomnography of obstructive sleep apnea syndrome patients with hypertension

作　　者：涂爱兰[1] 邹月娥[1] 欧阳清彦[1] 赵惠莉[1] 颜艳[1] 

机构地区：[1]广东省佛山市第二人民医院,广东佛山528000

出　　处：《现代中西医结合杂志》2012年第21期2298-2300,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨经鼻持续气道正压通气(nCPAP)治疗中重度阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压患者的疗效及其机制。方法根据睡眠呼吸暂停/低通气指数(AHI),经多导联睡眠呼吸监测仪筛选出中重度OSAS患者(AHI>20)合并高血压者81例(病史均2 a以上,且用降压药物治疗)。随机分为观察组41例和对照组40例,均行24 h动态血压监测,并予降压药物治疗,观察组加用nCPAP治疗。1个月后复查动态血压各指标和多导联睡眠参数。结果观察组治疗后平均动脉压显著下降(P<0.05),血压昼夜节律呈非杓形型比率下降(P均<0.05),多导联睡眠参数改善(P均<0.05),临床症状改善,与对照组比较有显著性差异(P<0.05)。结论 nCPAP是一种安全、有效、无创的方法,平均动脉压的变化、血氧饱和度(Sa(O2))、AHI、血压的昼夜节律等指标可反映其疗效,值得临床推广。Objective It is to approach the effect and mechanism of nasal continuous positive airway pressure （nCPAP） treatment on moderate to severe obstructive sleep apnea syndrome （OSAS） patients with hypertension. Methods According to sleep apnea/hypopnea index （AHI） ,eighty-one patients with moderate to severe OSAS （AHI 〉 20） filtered out through more leads for sleep apnea monitors monitoring, and with hypertension more than 2 years history and got antihypertensive drug thera- py. 81 cases were randomly divided into observation group with 41 cases and control group with 40 cases, each underwent 24 h ambulatory blood pressure monitoring, both groups medical treatment such as medication, observation group plus nCPAP treatment. After 1 month, the indexes of ambulatory blood pressure and multi-channel sleep parameters were reviewed. Re- suits After treatment, in observation group the mean arterial pressure was dropped significantly （ P 〈 0.05 ） , the circadian rhythm of blood pressure of non-dipper-shaped type ratio was decreased （ P 〈 0.05 ） , multi-lead sleep parameters were im- proved （P 〈 0.05） , clinical results were obvious. There was significant difference between both groups （P 〈 0. 05 ） Conclu- sion The therapy with nCPAP is a safe, effective, noninvasive method. Changes in mean arterial pressure, oxygen saturation, AHI, circadian rhythm of blood pressure and other indicators may reflect its effect can be worthy of promotion.

关 键 词：动态血压 阻塞性睡眠呼吸暂停综合征 高血压 气道正压通气 

分 类 号：R562[医药卫生—呼吸系统]