高血压合并OSAHS患者治疗前后血清Hcy、CRP、氧饱和度及血压变化及其临床意义  

Changes of SerumHcy,CRP,Oxygen Saturation and Blood Pressure in Patients with Hypertension and OSAHS before and after the Treatment and Their Clinical Significances

作　　者：徐立彦 詹燕[2] XU Li-yan;ZHAN Yan(Department of Heart and Respiration,Ganzi Tibetan AutonomousPrefecture People′s Hospital,Sichuan,Ganzi 626000,China;Department of Ultrasound,Ganzi Tibetan AutonomousPrefecture People′s Hospital,Sichuan,Ganzi 626000,China)

机构地区：[1]甘孜藏族自治州人民医院心内呼吸科,四川甘孜州626000 [2]甘孜藏族自治州人民医院超声科,四川甘孜州626000

出　　处：《标记免疫分析与临床》2019年第2期322-325,342,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的分析高血压合并阻塞性呼吸暂停低通气综合征(OSAHS)患者治疗前后血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)、氧饱和度及血压的变化及意义。方法选择医院收治的100例高血压患者,按是否合并OSAHS分为高血压组[n=46,呼吸暂停低通气指数(AHI)<5次/h]与合并组(n=54,AHI≥5次/h),均于治疗前后检测血清Hcy、CRP、血氧饱和度(SaO_2)水平,并检测动态血压变化,分析上述指标与高血压合并OSAHS病情变化的关系。结果合并组Hcy、CRP、AHI高于高血压组,最低SaO_2低于高血压组,其治疗后Hcy、CRP、AHI低于治疗前,SaO_2高于治疗前(P<0.05);合并组随OSAHS病情程度的提升,Hcy、CRP、AHI逐渐升高,最低SaO_2降低(P<0.05),各组治疗后Hcy、CRP、AHI水平均低于治疗前,最低SaO_2高于治疗前(P <0.05);高血压+轻度、中度、重度OSAHS组整体血压昼夜节律变化幅度高于高血压组(P<0. 05),治疗后,除高血压+轻度OSAHS组mSBP、mDBP外,各组血压较治疗前降低(P <0.05);高血压合并OSAHS患者Hcy、CRP与AHI、nSBP均呈正相关,与最低SaO_2呈负相关(P <0.05)。结论高血压合并OSAHS患者随OSAHS程度的上升,Hcy、CRP、AHI水平上升,最低SaO_2降低,且其Hcy、CRP的变化可影响患者通气功能及血压变化节律。Objective To analyze the changes of serum homocysteine(Hcy),C reactive protein(CRP),oxygen saturation(SaO 2 )and blood pressure in patients with hypertension and obstructive apnea hypopnea syndrome(OSAHS)before and after the treatment and their clinical significances. Methods 90 hypertensive patients admitted to the hospital were divided into the hypertension group[n=46,apnea hypopnea index(AHI)< 5 times/h] and the combined group(n=54,AHI ≥ 5 times/h)according to the presence of OSAHS.The levels of serum Hcy,CRP and SaO 2 were detected before and after the treatment,and changes of ambulatory blood pressure were also detected.The relationship between the above indexes and changes of the condition of hypertension with OSAHS were analyzed. Results The Hcy,CRP and AHI in the combined group were higher than those in the hypertension group,and the lowest SaO 2 was lower than that in the hypertension group.The Hcy,CRP and AHI in the combined group decreased while SaO 2 increased after the treatment( P <0.05).Levels of Hcy,CRP and AHI decreased,while SaO 2 increased in the combined group with the aggravation of OSAHS( P <0.05).Levels of Hcy,CRP and AHI in all groups decreased while SaO 2 increased after the treatment( P <0.05).The overall change of circadian rhythm of blood pressure in the hypertension plus mild,moderate and severe OSAHS groups was greater than that in the hypertension group( P <0.05).After the treatment,the blood pressure of each group was decreased( P <0.05),except for the mSBP and mDBP of hypertension plus mild OSAHS group.Hcy and CRP were positively correlated with AHI and nSBP in hypertensive patients with OSAHS,and negatively correlated with the lowest SaO 2 ( P <0.05). Conclusion Levels of Hcy,CRP and AHI increase and the lowest SaO 2 decreases with the aggravation of OSAHS in patients with hypertension and OSAHS.Furthermore,changes of Hcy and CRP can affect the ventilation function and the rhythm of blood pressure.

关 键 词：阻塞性呼吸暂停低通气综合征 高血压 同型半胱氨酸 C反应蛋白 氧饱和度 

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