高血压患者血脂水平与快速动眼型及非快速动眼型阻塞性睡眠呼吸暂停低通气综合征的相关性  

Correlation between blood lipid levels and rapid eye movement and non-rapid eye movement related obstructive sleep apnea hypopnea syndrome in patients with hypertension

作　　者：刘桂新[1] 于静[1] 程文立 LIU Guixin;YU Jing;CHENG Wenli(Hypertension Center,Department of Cardiology,Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内科高血压中心,北京市100029

出　　处：《中国动脉硬化杂志》2023年第4期343-349,共7页Chinese Journal of Arteriosclerosis

基　　金：2020年首都卫生发展科研专项(首发2020-2-2064);国家中医药管理局委托办事任务项目(GZYYGJ2019035)。

摘　　要：[目的]通过回顾性分析高血压合并和未合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的相关资料,探讨血脂水平与快速动眼型(REM)及非快速动眼型(non-REM)OSAHS的关系。[方法]回顾性分析2017年1月1日—2020年12月31日于北京安贞医院高血压科住院且入院前半年未服用降脂药物的患者478例。收集患者入院时的一般资料(性别、年龄、身高、体质量),检测总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)和高密度脂蛋白胆固醇(HDLC),记录氧减指数、最低血氧饱和度和平均血氧饱和度、睡眠呼吸暂停低通气指数(AHI)、24 h收缩压(24h SBP)和24 h舒张压(24h DBP);根据高血压患者是否合并OSAHS分为未合并OSAHS组和合并OSAHS组,对比两组临床资料,采用多因素线性回归方程分析OSAHS的相关影响因素;采用Spearman方程分析血脂水平与OSAHS各项指标的相关性;另根据OSAHS不同分型,分析REM OSAHS和non-REM OSAHS患者AHI与血脂指标的相关性。[结果]多因素线性回归分析显示,体质指数(BMI)、TG是OSAHS的相关影响因素(P<0.05)。Spearman方程分析显示,TC与BMI、微觉醒指数呈正相关(均P<0.05);HDLC与BMI、氧减指数、最长呼吸暂停时间、微觉醒指数、AHI呈负相关,与最低血氧饱和度呈正相关(均P<0.05);TG与BMI、氧减指数、微觉醒指数、AHI呈正相关,与最低血氧饱和度、平均血氧饱和度呈负相关(均P<0.05);在不同分型的OSAHS患者中,AHI_(non-REM)与TC、TG正相关,与HDLC负相关(均P<0.05);AHI_(REM)与TC、TG水平正相关(均P<0.05),与HDLC无相关性(P>0.05)。[结论]在高血压患者中,BMI和TG水平是OSAHS的独立危险因素,且TG水平可以作为一个独立危险因子与OSAHS严重程度正相关;non-REM OSAHS可能通过调节机体激素水平影响HDLC合成进而造成血脂变化。Aim To investigate the relationship between blood lipid levels and rapid eye movement(REM)and non-REM related obstructive sleep apnea hypopnea syndrome(OSAHS)by retrospective analysis of the related data of hypertension patients with OSAHS.Methods Retrospective analysis was made on 478 patients who were hospitalized in the Hypertension Department of Anzhen Hospital from January 1,2017 to December 31,2020 and did not take lipid-lowering drugs in the first half of the year.Collecting general data(gender,age,height and weight)of patients at admission,detecting total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDLC)and high density lipoprotein cholesterol(HDLC),and recording oxygen reduction index,minimum oxygen saturation,average oxygen saturation,sleep apnea hypopnea index(AHI),24 h systolic blood pressure(24h SBP)and 24 h diastolic blood pressure(24h DBP).According to whether hypertension patients had OSAHS or not,they were divided into two groups:without OSAHS group and with OSAHS group.The clinical data of the two groups were compared,and the related influencing factors of OSAHS were analyzed by multivariate linear regression equation,spearman equation was used to analyze the correlation between blood lipid level and various indexes of OSAHS.In addition,according to different types of OSAHS,the correlation between AHI and blood lipid indicators in REM OSAHS and non-REM OSAHS patients was analyzed.Results Multivariate linear regression analysis showed that body mass index(BMI)and TG were the relevant influencing factors of OSAHS(P<0.05).Spearman equation analysis showed that TC was positively correlated with BMI and arousal index(P<0.05),HDLC was negatively correlated with BMI,hypoxemia index,longest apnea time,arousal index and AHI,and positively correlated with the lowest oxygen saturation(all P<0.05);TG was positively correlated with BMI,hypoxemia index,arousal index and AHI,and negatively correlated with the lowest and average oxygen saturation(P<0.05);AHI_(non-REM)was positively corr

关 键 词：高血压 血脂水平 快速动眼型睡眠呼吸暂停低通气综合征 非快速动眼型睡眠呼吸暂停低通气综合征 

分 类 号：R5[医药卫生—内科学]