阻塞性睡眠呼吸暂停综合征合并高血压的影响因素分析  

Analysis of Influencing Factors of Complicated Hypertension in Patients with Obstructive Sleep Apnea-hypopnea

作　　者：石明[1] 唐友勇[1] 王正艳[1] 李威[1] 杨中卫[1] 

机构地区：[1]湖北医药学院附属东风医院呼吸内科,湖北十堰442008

出　　处：《医学综述》2016年第7期1417-1420,共4页Medical Recapitulate

摘　　要：目的探讨阻塞性睡眠呼吸暂停综合征(OSAHS)合并高血压的影响因素。方法选取2011年1月至2014年2月在湖北医药学院附属东风医院诊治的OSAHS患者316例,根据患者睡眠呼吸暂停低通气指数(AHI)及是否合并高血压将所有患者分为4组:单纯OSAHS组(96例)、轻度OSAHS合并高血压组(25例)、中度OSAHS合并高血压组(63例)、重度OSAHS合并高血压组(132例)。收集整理4组患者的性别、年龄、颈围、多导睡眠监测(PSG)参数、睡前和睡后收缩压及舒张压等临床资料,对比分析上述因素是否为患者高血压发病的影响因素。结果轻、中、重度OSAHS合并高血压组吸烟比例、体质指数(BMI)、Epwonh嗜睡评分评分分别为32.0%(8/25)、60.3%(38/63)、70.5%(93/132),(26.4±2.9)kg/m^2、(31.8±4.3)kg/m^2、(35.3±4.7)kg/m^2,(10.3±3.6)分、(15.6±3.8)分、(18.3±4.3)分,中、重度OSAHS合并高血压组上升指标高于轻度OSAHS合并高血压组,且重度OSAHS合并高血压组高于轻度OSAHS合并高血压组(P<0.05)。轻、中、重度OSAHS合并高血压组AHI、氧减指数(ODI)、90%以下氧减饱和度指数(Ts90%)、AI分别为12±4、25±5、50±20,14±4、28±6、51±17,6.6±2.5、19.4±9.3、47.9±10.3,21±6、28±4、43±11,中、重度OSAHS合并高血压组上述指标高于轻度OSAHS合并高血压组,且重度OSAHS合并高血压组高于中度OSAHS合并高血压组(P<0.05);轻、中、重度OSAHS合并高血压组LSaO_2、N3%分别为(86±6)%、(76±10)%、(61±20)%,15.1±4、10.2±3.5、6.4±1.7,中、重度OSAHS合并高血压组上述指标低于轻度OSAHS合并高血压组,且重度OSAHS合并高血压组低于中度OSAHS合并高血压组(P<0.05)。Logistic回归分析结果显示,AHI、BMI、Ts90%、AI、ODI、LSaO_2等为OSAHS患者高血压发病的危险因素(P<0.05)。结论患者的睡后舒张压和收缩压会随着OSAHS病情的加重而逐渐上升。Objective To explore the influencing factors of complicated hypertension in patients with obstructive sleep apnea-hypopnea syndrome（ OSAHS）. Methods Total of 316 OSAHS cases were selected in Dongfeng Affiliated Hospital of Hubei University from Jan. 2011 to Feb. 2014. According to the patient’ s sleep apnea hypopnea index（ AHI） and whether complicated with hypertension,all the patients were divided into 4 groups： the patients with pure OSAHS（ 96 cases）,the patients with mild OSAHS and hypertension（ 25cases）,the patients with moderate OSAHS and hypertension（ 63 cases）,the patients with severe OSAHS and hypertension（ 132 cases）. Then gender,age,neck circumference,systolic blood pressure and diastolic blood pressure before and after sleep were collected,and the relationship between these factors and hypertension was analyzed. Results The proportion of smoking,body mass index（ BMI）,Epwonh sleepiness scale score of the mild,moderate and severe OSAHS with hypertension group was 32. 0%（ 8 /25）,60. 3%（ 38 /63）,70. 5%（ 93 /132）,（ 26. 4 ± 2. 9） kg / m2,（ 31. 8 ± 4. 3） kg/m2,（ 35. 3 ± 4. 7） kg/m2,（ 10. 3 ± 3. 6）scores,（ 15. 6 ± 3. 8） scores,（ 18. 3 ± 4. 3） scores respectively,the index increase of the moderate and severe OSAHS with hypertension group were higher than the mild OSAHS hypertension group,and the severe group higher than the moderate group（ P 〈 0. 05）. AHI,oxygen desaturation index（ ODI）,90% less oxygen desaturation index（ Ts90%） of the mild,moderate and severe OSAHS with hypertension group were respectively： AI 12 ± 4,25 ± 5,50 ± 20,14 ± 4,28 ± 6,51 ± 17,6. 6 ± 2. 5,19. 4 ± 9. 3,47. 9 ± 10. 3,21 ± 6,28 ± 4,43 ± 11,the moderate and severe OSAHS with hypertension group higher than the mild group,and the severe group higher than the moderate group（ P 〈 0. 05）; LSaO2,N3% of the mild,moderate and severe OSAHS with hypertension group respectively（ 86 ± 6） %,（ 76 ± 10） %,（ 61 ± 20） %,15. 1 ± 4,10

关 键 词：阻塞性睡眠呼吸暂停综合征 高血压 睡眠呼吸暂停低通气指数 

分 类 号：R562.1[医药卫生—呼吸系统]