阻塞性睡眠呼吸暂停相关高血压的研究进展  

Research advances in hypertension associated with obstructive sleep apnea

作　　者：赵力博 徐伟豪 钱小顺[3,5] 刘霖[3,5] 范利[2,3] ZHAO Libo;XU Weihao;QIAN Xiaoshun;LIU Lin;FAN Li(Graduate School,Medical School of Chinese PLA,Beijing 100853,China;Department of Geriatric Cardiology,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China;Hainan Cadre's Sanitarium,Haikou 570100,Hainan Province,China;Department of Respiratory and Critical Care Medicine,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院研究生院,北京100853 [2]解放军总医院第二医学中心心血管内科,北京100853 [3]解放军总医院国家老年疾病临床医学研究中心,北京100853 [4]海南省军区海口离职干部休养所,海南海口570100 [5]解放军总医院第二医学中心呼吸与危重症医学科,北京100853

出　　处：《解放军医学院学报》2021年第4期451-455,共5页Academic Journal of Chinese PLA Medical School

基　　金：军队保健专项科研基金(19BJZ34;16BJZ25);国家老年疾病临床研究中心2018开放课题(NCRCG-PLAGH-2018008)。

摘　　要：阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与高血压之间存在双向关联。OSA是高血压的显著独立危险因素,50%~92%的OSA患者合并高血压病,而30%~50%的高血压患者同时患有OSA。OSA合并高血压时,即可做出OSA相关高血压的诊断。OSA相关高血压的治疗不同于普通高血压,需同时针对OSA和高血压进行治疗。改变生活方式是OSA相关高血压的治疗基础。持续气道正压通气(continuous positive airway pressure,CPAP)、口腔矫正器和外科治疗是OSA的有效治疗方式。在高血压药物治疗方面,血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂是我国指南中的推荐药物。应用利尿剂控制容量超负荷可能是治疗OSA相关高血压的有效方法。在OSA相关高血压的治疗过程中,血压水平跟踪、通气治疗及其治疗方式的随访均至关重要。A bidirectional association exists between obstructive sleep apnea(OSA)and hypertension.OSA is a significant independent risk factor for hypertension,approximately 50%to 92%of OSA patients are complicated with hypertension,while 30%to 50%of hypertensive patients coexist with OSA.The treatment of OSA related hypertension is different from that of common hypertension,and both OSA and hypertension should be treated simultaneously.Lifestyle modification is the basis for the treatment of OSA associated hypertension.Continuous Positive Airway Pressure(CPAP),oral orthotics and surgical treatment are effective in management of OSA.In the treatment of hypertension,angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are recommended drugs.Controlling volume overload with diuretics may be an effective treatment for OSA associated hypertension.Follow-up of blood pressure level,ventilatory therapy and other treatment methods are important in the management of OSA associated hypertension.

关 键 词：阻塞性睡眠呼吸暂停 高血压 持续气道正压通气 口腔矫正器 降压药 

分 类 号：R544.1[医药卫生—心血管疾病]