阻塞性睡眠呼吸暂停综合征与高血压相互关系的认识  

Understanding of the Relationship between Obstructive Sleep Apnea Syndrome and Hypertension

作　　者：蒋延文[1] 胡征[1] 李如 郭琳琪 

机构地区：[1]铁道部北京铁路总医院呼吸内科,北京100038

出　　处：《中国误诊学杂志》2002年第5期675-677,共3页Chinese Journal of Misdiagnostics

摘　　要：目的　探讨阻塞性睡眠呼吸暂停综合征 (OSAS)与高血压 (HT)的关系。方法　对 1999- 0 3～ 2 0 0 1- 10门诊就诊的主诉睡眠打鼾患者行多导睡眠图监测 ,符合诊断标准者为 OSAS组 ,余为对照组。对两组睡眠监测结果中的呼吸紊乱指数 (AHI)、夜间最低动脉血氧饱和度 (Sa O2 low)及睡前、晨起、治疗后的血压进行分析。结果　 OSAS组晨起血压较睡前血压明显升高 (P<0 .0 0 1)。对照组晨起血压较睡前血压明显升高 (P<0 .0 5 )。 OSAS组与对照组睡前血压无明显差异 (P>0 .0 5 ) ,晨起血压 OSAS组明显升高 (P<0 .0 0 1)。经持续气道正压通气 (CPAP)治疗后 OSAS组晨起血压较治疗前明显下降 (P<0 .0 0 1)。OSAS组晨起血压与 AHI呈正相关 ,与夜间最低动脉血氧饱和度呈负相关。结论　 OSAS患者血压增高与夜间缺氧有关 。Objective To explore the relationships between hypertension and obstructive sleep syndrome (OSAS).Methods Polysomnographic monitoring was performed for outpatients who complained of snoring during sleep and those who were coincident with diagnostic standard were included in OSAS group, while the other in the control group. The apnea/hypopnea index (AHI) ,nocturnal lowest SaO2(SaO2 )and blood pressures before sleeping,soon after getting up in the morning and after treatment were analyzed.Results In OSAS group,the blood pressure soon after getting up in the morning was significantly higher than that before sleep (P<0.001).In control group, it was also higher (P<0.05).The blood pressure before sleep between the OSAS and control groups showed no significant difference (P>0.05),but the blood pressure soon after getting up in the morning in OSAS group was higher than that in the control group (P<0.001). After continuous airway positive pres sure (CPAP) treatment,the blood pressure in the OSAS group decreased significantly compared with pre-treatment(P<0.001).The blood pressure in OSAS group positively correlated with AHI, and had a negative correlation with SaO2low.Conclusion The high blood pressure was related to nocturnal hypoxemia, and CPAP treatment was effective.

关 键 词：阻塞性睡眠呼吸暂停综合征 OSAS HT 并发症 高血压 病因学 

分 类 号：R563[医药卫生—呼吸系统] R544.1[医药卫生—内科学]