非高血压OSA患者动态血压相关性研究  

The correlation studies between ambulatory blood pressure and OSA in non-hypertensive patients

作　　者：王琳[1] 韩敏[1] 王保为 许贞菊[1] 许涛[1] WANG Lin;HAN Min;WANG Baowei;XU Zhenju;XU Tao(Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of Qingdao University,Qingdao,266000,China;Department of Otorhinolaryngology Head and Neck Surgery,Nanjing Tongren Hospital,Southeast University Medical College)

机构地区：[1]青岛大学附属医院耳鼻咽喉头颈外科,山东青岛266000 [2]东南大学医学院附属南京同仁医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2019年第7期666-669,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨非高血压OSA患者夜间血压变化情况及规律。方法:选取2017-12-2018-06期间就诊、既往未诊断为高血压且诊室血压小于130/85mmHg的患者,睡眠监测室行PSG检查确诊为OSA的患者89例为OSA组;选取既往未诊断为高血压且诊室血压小于130/85mmHg的声带息肉、声带小结、志愿者,行PSG检查确诊为非OSA的40例患者为非OSA组。整夜PSG检查的同时进行基于脉搏传导时间的动态血压监测,监测患者夜间睡眠时每博血压数值。记录患者整夜收缩压平均值、舒张压平均值、>12mmHg血压上升指数、血压平均上升数值、血压最高上升数值、最高收缩压,进行比较。结果:2组之间各项监测指标均差异有统计学意义(P<0.05);重度OSA组与轻度组、中度组间各项数值均差异有统计学意义(P<0.05);重度组组内比较:呼吸事件引起的血压波动与自发血压波动差异有统计学意义(P=0.004),≥55岁者与<55岁者比较,舒张压平均值(P=0.032)、血压上升指数(P=0.037)、血压平均上升数值(P=0.032)、血压最高上升数值(P=0.045)均差异有统计学意义。结论:同步于PSG的动态血压监测有助于OSA患者高血压疾病的早期诊断和预防。Objective:To discuss the changes and rules of nighttime blood pressure in obstructive sleep apnea(OSA)patients without hypertension.Method:Eighty-nine non-hypertensive patients whose office blood pressure was lower than 130/85 mmHg and diagnose with OSA by PSG in sleep monitoring room were choose as the research group.Forty non-hypertensive and polyp of vocal cord or vocal nodules patients whose office blood pressure was lower than 130/85 mmHg and diagnose with non-OSA by PSG were choose as matched group.All the patients were in treatment in our hospital from December 2017 to June 2018.All the patients got PSG,and the same time got the ambulatory blood pressure monitoring based on pulse transit time all night.Compared the mean value of systolic blood pressure,the mean value of diastolic blood pressure.Higher than 12 mmHg blood pressure rise index,the mean rise in blood pressure.the highest increase in blood pressure.maximum systolic pressure between the study group and the marched group all night.Result:The difference of all the test index between the study group and the marched group was significant(P<0.05).In OSA patients.the difference of all the test index between the severe OSA group and the mild OSA group or the moderate OSA group was significant(P<0.05).In severe OSA group.the difference between the fluctuation of blood pressure caused by respiratory events and spontaneous blood pressure fluctuation was significant(P=0.004).The difference of the mean value of diastolic blood pressure(P=0.032)blood pressure rise index(P=0.037)the mean rise in blood pressure(P=0.045)between age 55 or older patients and under 55 years old patients.Conclusion:Ambulatory blood pressure monitoring synchronizatied in PSG contribute to the early diagnosis and prevention of hypertension in OSA patients.

关 键 词：非高血压患者 睡眠呼吸暂停 阻塞性 动态血压 

分 类 号：R563.8[医药卫生—呼吸系统]