绝经前后女性阻塞性睡眠呼吸暂停低通气综合征患者血压影响因素分析  

Influencing Factors on Blood Pressure in Perimenopausal Women with Obstructive Sleep Apnea-hypopnea Syndrome

作　　者：许华俊[1] 李庆云[1] 蓝孝斐[1] 周丽娜[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院呼吸科,上海市200025

出　　处：《中国全科医学》2013年第19期2239-2242,2247,共5页Chinese General Practice

基　　金：国家自然科学基金资助项目(81070068)

摘　　要：目的探讨女性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者绝经前、后血压影响因素。方法将153例2009—2011年就诊于上海交通大学附属瑞金医院睡眠中心的女性OSAHS患者按是否绝经分成绝经前患者(n=37)与绝经后患者(n=116)。比较两组患者的一般特征〔年龄、体质指数(BMI)、颈围、Epwoyth嗜睡量表(ESS)得分〕、多导睡眠图(PSG)监测指标及血压差异,并分析血压和上述因素的相关性。结果绝经后女性OS-AHS患者和绝经前比较舒张压〔(79±10)mm Hg比(85±10)mm Hg〕升高,差异有统计学意义(P<0.05)。在校正了混杂因素以后,氧减指数(ODI)是绝经前女性OSAHS患者收缩压和舒张压的影响因素(β=0.481;P=0.002;β=0.418,P=0.010);BMI是绝经后女性OSAHS患者收缩压和舒张压的影响因素(β=0.287,P=0.002;β=0.257,P=0.006);AHI是绝经后女性OSAHS患者舒张压的影响因素(β=0.228,P=0.015);年龄是绝经前女性OSAHS患者收缩压的影响因素(β=0.288,P=0.047)。结论在女性OSAHS患者中,绝经后的血压高于绝经前,并且以舒张压升高为主;绝经前后影响女性OSAHS患者血压的因素存在差异。Objective To investigate the influencing factors on blood pressure in perimenopausal women with obstructive sleep apnea - hypopnea syndrome （OSAHS） . Methods One hundred and fifty - three women with OSAHS in Sleep Medi- cine Center of Ruijin Hospital from January 2009 to January 2011 were divided into pre - menopausal group （n = 37 ） and post - menopausal group （n = 116） by menstrual history. The general parameters including age, neck circumference, body mass index （BMI） and Epworth score, as well as polysomnographic features and blood pressure readings were compared between the two groups. And the correlations between the above indexes and blood pressure readings were analyzed. Results The diastolic blood pressure （DBP） was significantly higher in post - menopausal OSAHS patients than in pre - menopausal OSAHS patients [ （79 ± 10） mm Hg vs. （ 85 ± 10） mm Hg （ P 〈 0.05 ） ]. After adjustment for confounding factors, the systolic blood pressure （SBP） and DBP were positively correlated with ODI in pre - menopausal OSAHS patients （β = 0. 481, P = 0. 002 ; β = 0.418, P =0. 010）, and with in post - menopausal OSAHS patients （β =0. 287, P =0. 002, β =0. 257, P =0. 006）. AHI mainly af- fected DBP in post - menopausal women patients （β = 0. 228, P = 0. 015 ） . Age mainly affected SBP in pre - menopausal OSAHS patients （β = 0. 228, P = 0. 047） . Conclusion In female OSAHS patients, the blood pressure is higher in postmenopausal stage than in premenopausal stage, especially for DBP. And the factors influencing blood pressure are different in pre - menopausal and post - menopausal periods for women with OSAHS.

关 键 词：睡眠呼吸暂停 阻塞性 高血压 绝经 呼吸暂停低通气指数 

分 类 号：R563.8[医药卫生—呼吸系统]