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目的 分析外周血内C反应蛋白(CRP)、血脂及氨基-末端脑钠肽前体(NT-proBNP)水平对中老年高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血压及心率变异性的影响,探讨其临床意义.方法 选取我院2013年8月至2017年4月收治的253例中老年高血压合并OSAHS患者,按照其呼吸紊乱指数(AHI),将患者分别纳入轻度OSAHS组(n=96)、中度OSAHS组(n=68)、重度OSAHS组(n=89),并选取同期80例单纯高血压患者,纳入单纯高血压组.检测各组患者外周血CRP、血脂、NT-proBNP水平以及血压、心率变异性,运用直线回归法,计算CRP、血脂、NT-proBNP与血压及心率变异性的相关性.结果 单纯高血压组、轻度OSAHS组、中度OSAHS组、重度OSAHS组患者CRP、NT-proBNP逐渐升高,差异有统计学意义(P0.05).重度OSAHS组日间SBP、DBP变异高于单纯高血压组,其夜间SBP、DBP变异高于其他各组,差异有统计学意义(P<0.05).单纯高血压组、轻度OSAHS组、中度OSAHS组、重度OSAHS组患者全部窦性心博N-N间期或R-R间期的标准数(SDNN)、相邻N-N间期或R-R间期差值的均方根(rMSSD)、高频谱(HF)逐渐降低,低频谱(LF)、LF/HF逐渐升高,差异有统计学意义(P<0.05).直线回归分析示,CRP、NT-proBNP与患者夜间血压变异性、LF、LF/HF呈正相关,与SDNN、rMSSD、HF呈负相关(P<0.05).结论 外周血内CRP、NT-proBNP与中老年高血压合并OSAHS患者血压及心率变异性均具有密切关联,据此探索治疗方案有望为患者预后质量的改善及心血管事件的预防奠定良好基础.“,”Objective To analyze the relationship of peripheral blood C reactive protein (CRP),blood lipid and N-terminal pro brain natriuretic peptide (NT-proBNP) levels in elderly hypertensive patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with the blood pressure and heart rate variability in patients and explore its clinical significance. Methods In 253 cases of elderly patients with hypertension and OSAHS were selected for the study;according to the apnea hypopnea index (AHI),the patients were divided into mild OSAHS group (n=96),moderate OSAHS group (n=68) and severe OSAHS group (n=89),and 80 cases of hypertension patients were selected into the simple hypertension group. The peripheral blood CRP,blood lipid,NT-proBNP levels,blood pressure and heart rate variability were detected. The correlation between CRP,blood lipid,NT-proBNP and blood pressure and heart rate variability were calculated by linear regression method. Results In hypertension group,mild OSAHS group,moderate OSAHS group and severe OSAHS group of patients the levels of CRP and NT-proBNP were gradually increased;the difference was statistically significant (P0.05). The diurnal variations of SBP and DBP in the severe OSAHS group were higher than those in the simple hypertension group ,and the variances of night SBP and DBP were higher than those of the other groups;the difference was statistically significant (P<0.05). In the simple hypertension group,mild OSAHS group, moderate OSAHS group and severe OSAHS group ,the levels of SDNN ,rMSSD and HF were gradually decreased ,but the levels of LF and LF/HF were increased gradually;the differences were statistically significant(P<0.05). Linear regression analysis showed that CRP and NT-proBNP were positively related to nocturnal blood pressure variability,LF and LF/HF, but were negatively correlated with SDNN ,rMSSD and HF(P<0.05). Conclusions The peripheral blood CRP ,blood pressure,heart rate and NT-proBNP in elderly patients with hypertension and OSAHS variability were closely related. Based on this observation ,better prevention and treatment could be developed for patients with cardiovascular diseases.