左旋氨氯地平对高龄老年高血压伴阻塞性睡眠呼吸暂停低通气综合征患者的血压干预效果研究  

Study on the Intervention Effects of Levamlodipine on Elderly Patients with Hypertension Complicated with Obstructive Sleep Apnea-hypopnea Syndrome

作　　者：王维维[1] 高春燕[1] 

机构地区：[1]哈励逊国际和平医院老年病一科,河北衡水053000

出　　处：《中国药房》2018年第3期386-389,共4页China Pharmacy

基　　金：河北省2013年医学科学研究课题计划(No.20130343)

摘　　要：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高龄(≥80岁)老年高血压(HP)的相关性及左旋氨氯地平对高龄老年HP伴OSAHS降压效果的影响。方法:回顾性分析90例高龄老年HP患者,根据是否伴有OSAHA分为HP组(30例)及HP+OSAHS组(60例),后者再根据OSAHS严重程度分为HP合并轻(20例)、中(21例)、重(19例)度OSAHS组(记为HP+OSAHS1、HP+OSAHS_2、HP+OSAHS_3组),所有患者均给予苯磺酸左旋氨氯地平片2.5 mg,1日1次,晨间顿服,给药4周,OSAHA患者给予持续正压通气治疗阻塞性呼吸暂停。4周后观察各组患者颈围、体质量指数(BMI)、呼吸暂停低通气指数(AHI)、指端动脉血氧饱和度(SaO_2)、收缩压和舒张压(白昼、夜间及24 h);采用Spearman秩相关性分析AHI、SaO_2与收缩压和舒张压的相关性。结果:HP+OSAHS组患者的颈围、BMI、AHI、白昼收缩压、夜间及24 h收缩压和舒张压均显著高于HP组,SaO_2显著低于HP组;HP+OSAHS_2、HP+OSAHS_3组患者颈围、BMI显著高于HP组,且HP+OSAHS_3组>HP+OSAHS_2组,SaO_2显著低于HP组,且HP+OSAHS_3组<HP+OSAHS_2组;HP+OSAHS各组患者AHI、夜间及24 h收缩压和舒张压显著高于HP组,且HP+OSAHS_3组>HP+OSAHS_2组>HP+OSAHS1组;HP+OSAHS_3组患者白昼收缩压显著高于HP组,以上差异均有统计学意义(P<0.001);各组患者白昼舒张压比较差异无统计学意义(P>0.05)。Spearman秩相关性分析结果显示,夜间及24 h收缩压和舒张压与AHI呈显著正相关(P<0.001),与SaO_2呈显著负相关(P<0.001)。结论:OSAHS可使高龄老年HP患者血压显著升高,左旋氨氯地平对高龄老年HP伴不同程度OSAHS患者的降压效果有影响,应根据病情调整用药。OBJECTIVE：To explore the correlation between obstructive sleep apnea-hypopnea syndrome（OSAHA）and elderly（≥80 year-old）hypertension（HP）,and the effects of levamlodipine on antihypertensive effect of elderly patients with HPcomplicated with OSAHA.METHODS：A total of 90 elderly HP patients were analyzed retrospectively and divided into HP group（30 cases）and HP＋OSAHA group（60 cases）according to whether accompanied by OSAHA or not.The latter was divided into HP complicated with mild OSAHA group（20 cases,HP＋OSAHA1group）,hypertension complicated with medium OSAHA group（21 cases,HP＋OSAHA2group）,HP complicated with severe OSAHA group（19 cases,HP＋OSAHA3group）according the severity of OSAHA.All patients were given Levamlodipine besylate tablet 2.5 mg taken at a draught,qd,in the morning,for 4weeks,while continuous positive pressure veritilation was given to treat the obstructive apnea in OSAHA patients.Neck circumference,BMI,apnea hypoventilation index（AHI）,Sa O2,SBP and DBP（daytime,evening and 24 h）were observed in each group 4 weeks later.The correlation of AHI and Sa O2with SBP and DBP was analyzed by Spearman rank correlation.RESULTS：Neck circumference,BMI,AHI,daytime SBP,evening and 24 h SBP and DBP of HP＋OSAHA group were significantly higher than those of HP,while Sa O2of HP＋OSAHA group was significantly lower than that of HP group.Neck circumference and BMI of HP＋OSAHA2group and HP＋OSAHA3group were significantly higher than those of HP group;the HP＋OSAHA3group were higher than the HP＋OSAHA2group.Sa O2of HP＋OSAHA2group and HP＋OSAHA3group were significantly lower than that of HP group;the HP＋OSAHA3group was lower than the HP＋OSAHA2group.AHI,evening and 24 h SBP and DBP of HP＋OSAHA group were significantly higher than 6those of HP group;the descending order was as follows：HP＋OSAHA3groupHP＋OSAHA2groupHP＋OSAHA1group.Daytime SBP of HP＋OSAHA3group was significantly higher than that of HPgroup,with statistical significance（P〈0.001）;t

关 键 词：左旋氨氯地平 睡眠呼吸暂停综合征 高龄 高血压 

分 类 号：R544.1[医药卫生—心血管疾病] R766[医药卫生—内科学]