基于脉搏传导时间的血压监测与阻塞性睡眠呼吸暂停的相关性  

Correlation between blood pressure monitoring based on pulse transit time and obstructive sleep apnea

作　　者：陈一冰 王巧云 李丹 解立新 Chen Yibing;Wang Qiaoyun;Li Dan;Xie Lixin(Department of Respiratory and Critical Care Medicine,First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Section of Respiratory and Critical Care Medicine,Eighth Medical Center,Chinese PLA General Hospital,Beijing 100091,China)

机构地区：[1]中国人民解放军总医院第一医学中心呼吸与危重症医学科,北京100853 [2]中国人民解放军总医院第八医学中心呼吸与危重症医学部,北京100091

出　　处：《中华老年多器官疾病杂志》2023年第9期683-686,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨基于脉搏传导时间(PTT)的逐博监测血压与阻塞性睡眠呼吸暂停(OSA)疾病的相关性。方法回顾性分析2021年6月到2022年1月中国人民解放军总医院第一医学中心呼吸与危重症医学科睡眠呼吸监测中心57例疑似OSA患者的睡眠监测参数和基于PTT监测的血压变化情况。收集患者的临床资料,呼吸事件指数(REI),氧减指数(ODI),低于90%的血氧饱和度时间占比(T90%),血压升高指数,不同体位的收缩压,舒张压等监测参数。按照OSA的严重程度分为轻度组(18例)和中重度组(24例),按照OSA患者的年龄分为<60岁组(28例)和≥60岁组(14例),按照性别分为男性(31例)和女性组(11例)。采用SPSS 26.0软件进行数据分析。组间比较采用独立样本t检验。采用Pearson相关性分析REI,ODI,T90%等指标与血压升高指数的相关性。结果最终共50例患者纳入本研究,确诊OSA的患者42例,年龄(53.60±11.93)岁。OSA患者的REI、ODI、T90%均与血压升高指数呈中等程度正相关(r=0.651,0.633,0.714;均P<0.001);最低SpO_(2)与血压升高指数呈负相关(r=-0.582;P<0.001)。平均血压升高幅度及最大血压升高幅度与年龄呈弱负相关(r=-0.353、-0.332;P<0.05)。轻度OSA患者和中重度OSA患者血压升高指数、血压升高次数、平均收缩压、最高收缩压、仰卧位收缩压、仰卧位舒张压情况比较,差异均有统计学意义(均P<0.05)。年龄≥60岁组与年龄<60岁组OSA患者平均血压升高幅度和最大升高幅度比较,差异均有统计学意义[(13.64±0.84)和(15.11±1.64)mmHg,(23.71±6.58)和(25.36±17.85)mmHg;P<0.05]。男性OSA患者在血压升高指数、平均血压升高幅度和最大血压升高幅度均显著高于女性OSA患者,差异均有统计学意义[(21.75±19.96)和(7.02±3.87)次/h,(14.97±1.62)和(13.64±0.92)mmHg(1 mmHg=0.133 kPa),(34.58±17.10)和(22.73±7.23)mmHg;P<0.05]。结论基于PTT的逐博血压测定能够反映OSA患者夜间的血压升高情况。OSA的�Objective To explore the correlation of pulse transit time(PTT)-based beat-by-beat blood pressure monitoring with obstructive sleep apnea(OSA).Methods A retrospective analysis was conducted on 57 suspected OSA patients admitted in the Sleep Respiratory Monitoring Center,Department of Respiratory and Critical Care Medicine of the First Medical Center of Chinese PLA General Hospital from June 2021 to January 2022.Their sleep monitoring parameters and blood pressure changes based on PTT were collected and analyzed.The clinical data,respiratory event index(REI),oxygen desaturation index(ODI),time proportion of blood oxygen saturation below 90%(T90%),blood pressure increase index,and systolic and diastolic blood pressure in different postures were recorded and collected.According to the severity of OSA,age and gender,the patients were respectively divided into a mild OSA group(18 cases)and a moderate to severe OSA group(24 cases),a<60-year-old group(28 cases)and a≥60-year-old group(14 cases),and a male group(31 cases)and a female group(11 cases).SPSS statistics 26.0 was used for data analysis.Independent-samples t-test was employed for intergroup comparison.Pearson correlation analysis was applied to analyze the correlation of REI,ODI,T90%and blood pressure increase index.Results Finally,50 patients were enrolled in the study,and 42 of them[a mean age of(53.60±11.93)years]were confirmed with OSA.In the OSA patients,REI,ODI and T90%were moderately positively correlated with blood pressure increase index(r=0.651,0.633,0.714,P<0.001),while the lowest SpO_(2) value was negatively correlated with the blood pressure increase index(r=-0.582;P<0.001).The increments of average and maximum blood pressure were weakly negatively correlated with age(r=-0.353,-0.332;P<0.05).Significant differences were observed between the patients with mild OSA and those with moderate to severe OSA in blood pressure increase index,number of blood pressure increase,average systolic blood pressure,maximum systolic blood pressure,supine systolic b

关 键 词：阻塞性睡眠呼吸暂停 高血压 脉搏传导时间 睡眠监测 

分 类 号：R544.1[医药卫生—心血管疾病]