短期持续正压通气治疗对不同性别OSAHS合并高血压患者降压疗效的比较  

Antihypertensive effects of short-term continuous positive airway pressure therapy on obstructive sleep apnea hypopnea syndrome patients of different genders combined with hypertension

作　　者：盛红宇[1] 姚晓光[1] 木拉力别克 邵亮[1] 汪迎春[1] 洪静[1] 欧阳玮琎[1] 成秋艳[1] 孙乐[1] 童玲[1] 索菲娅.阿布利克木 李南方[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),新疆乌鲁木齐830001

出　　处：《中华全科医学》2016年第1期9-11,共3页Chinese Journal of General Practice

基　　金：国家自然科学基金(81160015)

摘　　要：目的探讨短期持续正压通气(CPAP)治疗对不同性别阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)合并高血压患者降压疗效的差异。方法入选2012年11月—2013年5月在新疆维吾尔自治区人民医院高血压科且经多导睡眠监测确诊的OSAHS合并高血压住院患者100例,按性别分为男性组与女性组,在原有降压药物治疗基础上,给予连续每日夜间CPAP治疗(>6 h/晚)1周,监测每日血压水平,治疗前后血压及血压达标率做组内自身前后对照比较,治疗前后血压差值(下降幅度)行组间比较。结果1男性CPAP治疗第7日晨起平均动脉压[(103.4±10.4)mm Hg vs.(113.4±11.7)mm Hg(P<0.05),1mm Hg=0.133 k Pa]低于治疗前;女性治疗前后血压差异无统计学意义(P>0.05);男性第7日晨起平均动脉压下降幅度[(10.1±12.5)mm Hg vs.(1.7±6.7)mm Hg,P<0.05]大于女性。2男性CPAP治疗第7日晨起收缩压达标率[79.0%vs.43.2%(P<0.05)]、晨起舒张压达标率[79.0%vs.28.4%(P<0.05)]高于治疗前;女性仅晨起舒张压达标率[89.5%vs.57.8%(P<0.05)]高于治疗前。结论短期CPAP治疗对男性患者降压疗效优于女性,临床诊治过程中应根据不同性别特点区别对待。Objective To compare the difference in antihypertensive effects of short-term continuous positive airway pres- sure （CPAP） between man and women obstructive sleep apnea hypopnea syndrome （OSAHS） with hypertension. Meth- ods Total 100 OSAHS inpatients confirmed by polysomnography combined with hypertension in our department were en- rolled between November 2012 and May 2013, and were divided into two groups based on gender. All patients received nocturnal CPAP therapy for 7 days （ 〉 6 h/night） on the basis of prior antihypertensive medications treatment, daily blood pressure was measured. The blood pressure value and proportion of patients reaching their blood pressure targets were compared within each group, and the blood pressure lowered by the treatment was compared between the two groups. Re- sults ①post-treatment morning mean blood pressure was significantly lowered at day 7 than pre-treatment value in male patients[ （103.4 ± 10.4） mm Hg vs. （113.4 ± 11.7） mm Hg,P 〈0.05,1 mm Hg =0. 133 kPa] ,whereas similar re- suits were not observed in female patients; lowering scope of mean atrial blood pressure was significantly higher at day 7 in males patients than that in female patients[ （ 10.1 ± 12.5） mm Hg vs. （ 1.7 ±6.7） mm Hg,P 〈0.05） ]. ②The propor- tion of patients reaching their post-therapy morning systolic blood pressure and of diastolic blood pressure targets of at day 7 were higher than the pre-treatment in male patients （79.0% vs. 43.2%, P 〈 0.05 and 79.0% vs. 28.4%, P 〈 0.05） ;only the proportion of reaching morning diastolic blood pressure targets of post-treatment is significantly higher than the pre-treatment in female patients （ 89.5% vs. 57.8% , P 〈 0.05 ）. Conclusion The effects of short-term CPAP therapy in male CPAP patients with hypertension are superior to those in female patients, and thus gender-specific treat- ment should be considered in clinical settings.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 高血压 性别 持续正压通气 

分 类 号：R459.6[医药卫生—治疗学] R544.1[医药卫生—临床医学]