OSAHS伴高血压患者AHI、血氧变化与超声心动图、颈动脉功能参数的关系  

Correlation of AHI and blood oxygen changes with echocardiography and carotid artery function parameters in patients with OSAHS and hypertension

作　　者：李新[1,2] 李亮[2] 李青[2] 李涛平 LI Xin;LI Liang;LI Qing(Sleep Medicine Center,Nanfang Hospital,Southern Medical University,Guangzhou Guangdong 510515,China;Department of General,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan Guangdong 528400,China)

机构地区：[1]南方医科大学南方医院睡眠医学中心,广东广州510515 [2]中山市中医院综合科,广东中山528400

出　　处：《临床和实验医学杂志》2022年第14期1558-1562,共5页Journal of Clinical and Experimental Medicine

基　　金：广东省医学科学技术研究基金项目(编号:B2021027)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者的呼吸暂停低通气指数(AHI)、血氧饱和度指标与患者心脏重构、颈动脉功能参数变化的关系。方法采用前瞻性研究,选取2018年6月至2021年12月中山市中医院收治的OSAHS合并高血压患者100例作为研究组,单纯高血压患者100例作为对照组。比较两组患者的左心室收缩末期内径(LVDs)、左心室舒张末期内径(LVDd)、舒张末期左心室后壁厚度(LVPWdT)、左室射血分数(LVEF)、颈内动脉内径(AO)、颈总动脉扩张性(DC)、顺应性(CC)、内径变化幅度(Dis)、颈动脉内膜中膜厚度(IMT)、AHI、夜间平均血氧饱和度(MSaO_(2))、氧减饱和度事件累积时间比率(DCT)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP);采用Pearson相关性分析法探讨AHI、MSaO_(2)与患者心脏重构指标、颈动脉超声指标的关系。结果研究组患者的LVDs、LVDd、LVPWT值为(39.64±2.50)、(53.84±3.70)、(13.73±1.94)mm,均高于对照组[(37.51±2.33)、(51.46±3.35)、(12.07±2.03)mm],LVEF值为(57.60±4.33)%,低于对照组[(59.27±5.07)%],差异均有统计学意义(P<0.05)。研究组患者的AO、DC、CC、Dis、AHI、DCT值为(36.50±2.41)mm、(27.57±1.88)mm、(1.09±0.24)×10^(-1)/kPa、(364.80±34.10)mm^(2)/kPa、32.54±5.11、(0.24±0.07)%,均高于对照组[(34.83±2.16)mm、(26.24±2.15)mm、(0.96±0.27)×10^(-1)/kPa、(349.00±32.80)mm^(2)/kPa、3.04±0.96、(0.16±0.05)%],MSaO_(2)值为(95.64±1.24)%,低于对照组[(97.38±0.95)%],差异均有统计学意义(P<0.05);两组患者IMT、nSBP、dSBP值比较,差异均无统计学意义(P>0.05)。研究组患者的AHI值与LVDs、LVDd、LVPWd呈正相关(P<0.05),MSaO_(2)与LVDs、LVDd、LVPWd呈负相关(P<0.05);研究组患者的AHI值与AO值呈正相关(P<0.05),MSaO_(2)与AO、CC值呈负相关(P<0.05)。结论OSAHS合并高血压患者较单纯的高血压患者心脏重构更加明显,颈动脉的弹性变差,患者的AHI及低氧水平在�Objective To investigate the relationship between sleep apnea hypopnea index(AHI)and blood oxygen saturation index in patients with obstructive sleep apnea syndrome(OSAHS)complicated with hypertension,cardiac remodeling and carotid artery function parameters.Methods Prospective studies was used,and 100 patients with OSAHS complicated with hypertension(study group)and 100 patients with simple hypertension who collected evidence from June 2018 to December 2021 in Traditional Chinese Medicine of Zhongshan were selected as the control group.The left ventricular end-systolic diameter(LVDs),left ventricular end-diastolic diameter(LVDd),left ventricular posterior wall thickness at end-diastole(LVPWdT),left ventricular ejection fraction(LVEF),internal carotid artery diameter(AO),common carotid artery distensibility(DC),compliance(CC),inner diameter variation(Dis),carotid intima-media thickness(IMT),AHI,nighttime mean oxygen saturation(MSaO_(2)),oxygen desaturation event cumulative time ratio(DCT),nighttime mean systolic blood pressure(nSBP),nighttime mean diastolic blood pressure(nDBP)were compared between the two groups.The relationship between AHI,MSaO_(2),cardiac remodeling index and carotid artery ultrasound index was analyzed by Pearson correlation.Results The levels of LVDs,LVDd and LVPWd in the study group were(39.64±2.50),(53.84±3.70),(13.73±1.94)mm,which were higher than those in the control group[(37.51±2.33),(51.46±3.35)(12.07)±2.03)mm],the level of LVEF was(57.60±4.33)%,which was lower than that in the control group[(59.27±5.07)%],and the differences were statistically significant(P<0.05).The levels of AO,DC,CC,Dis,AHI and DCT in the study group were(36.50±2.41)mm,(27.57±1.88)mm,(1.09±0.24)×10^(-1)/kPa,(364.80±34.10)mm^(2)/kPa,32.54±5.11,(0.24±0.07)%,which were higher than those in the control group[(34.83±2.16)mm,(26.24±2.15)mm,(0.96±0.27)×10^(-1)/kPa,(349.00±32.80)mm^(2)/kPa,3.04±0.96,(0.16±0.05)%],the level of MSaO_(2)in the study group was(95.64±1.24)%,which was lower than that in t

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 高血压 呼吸暂停低通气指数 血氧饱和度 心脏重构 颈动脉功能参数 

分 类 号：R766[医药卫生—耳鼻咽喉科] R544.1[医药卫生—临床医学]