高血压合并阻塞性睡眠呼吸暂停综合征患者动态血压昼夜节律及变异性研究  

Ambulatory blood pressure circadian rhythm and its variability in hypertensive patients complicated with OSAS

作　　者：廖文君 谢佳佳[1] 余天浩[1] 伍灏堃 李晓伟 LIAO Wenjun;XIE Jiajia;YU Tianhao;WU Haokun;LI Xiaowei(Department of Cardiology,Guangdong Second Provincial General Hospital/Guangdong Provincial Emergency Hospital,Guangzhou City,Guangdong Province,510317,China)

机构地区：[1]广东省第二人民医院/广东省应急医院心血管内科,广东广州510317

出　　处：《蛇志》2024年第4期487-491,共5页Journal of Snake

摘　　要：目的探讨高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)患者的24 h动态血压昼夜节律及变异性。方法选择2021年10月至2023年10月在我院治疗的100例高血压患者为研究对象,通过睡眠监测分析后,将患者分为单纯高血压组(41例),轻度OSAS组(33例),中重度OSAS组(26例)。所有患者均行24 h动态血压检测,比较3组患者的血压昼夜节律及变异性。结果与单纯高血压组比较,轻度OSAS组和中重度OSAS组患者24hSBP、24hDBP、dSBP、dDBP、nSBP、nDBP显著升高,中重度OSAS组高于轻度OSAS组,差异均有统计学意义(均P<0.05);与单纯高血压组比较,轻度OSAS组和重度OSAS组患者收缩压昼夜差值和舒张压昼夜差值显著降低,中重度OSAS组低于轻度OSAS组,差异均有统计学意义(均P<0.05);与单纯高血压组比较,轻度OSAS组和中重度OSAS组非杓型患者占比明显升高,且中重度OSAS组非杓型患者占比高于轻度OSAS组,差异均有统计学意义(均P<0.05)。与单纯高血压组比较,轻度OSAS组和中重度OSAS组患者nSBP-SD和nDBP-SD显著升高,中重度OSAS组高于轻度OSAS组,差异均有统计学意义(均P<0.05)。结论高血压合并OSAS患者24 h动态血压显著升高,较单纯高血压患者更易出现昼夜血压节律异常,且高血压合并中重度OSAS患者的血压调节功能损害程度更大。Objective To investigate the circadian rhythm of 24h ambulatory blood pressure in patients with hypertension complicated with obstructive sleep apnea(OSAS),and to analyze the variability of circadian rhythm.Methods 100 patients with hypertension who were admitted to hospital from October 2021 to October 2023 were selected as the study subjects.After sleep monitoring analysis,they were divided into single hypertension group(41 cases),mild OSAS group(33 cases)and moderate to severe OSAS group(26 cases).All patients underwent 24h ambulatory blood pressure detection,and the blood pressure circadian rhythm and variability of the three groups were compared.Results Compared with single hypertension group,24hSBP,24hDBP,dSBP,dDBP,nSBP and nDBP in mild OSAS group and moderate to severe OSAS group were significantly increased,and moderate to severe OSAS group was higher than mild OSAS group(all P<0.05).The diurnal difference of systolic blood pressure and diurnal difference of diurnal diastolic blood pressure in mild OSAS group and moderate to severe OSAS group were significantly lower than those in mild OSAS group(all P<0.05).Compared with the single hypertension group,the proportion of non-arytenoid patients in the mild OSAS group and the moderate to severe OSAS group was significantly increased,and the proportion of non-arytenoid patients in the moderate to severe OSAS group was higher than that in the mild OSAS group(all P<0.05).Compared with the single hypertension group,nSBP-SD and nDBP-SD were significantly increased in the mild OSAS group and the moderate to severe OSAS group,and the moderate to severe OSAS group was higher than the mild OSAS group(all P<0.05).Conclusion 24h ambulatory blood pressure is significantly increased in patients with hypertension combined with OSAS,and abnormal circadian blood pressure rhythm is more likely than patients with simple hypertension,and the degree of impairment of blood pressure regulation function is greater in patients with hypertension combined with moderate to severe OSAS.

关 键 词：高血压病 阻塞性睡眠呼吸暂停 昼夜节律 血压变异性 

分 类 号：R544.1[医药卫生—心血管疾病]