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目的 探讨阻塞性睡眠呼吸暂停 (OSA)夜间低氧血症对动态血压变化的影响。方法 选择阻塞性睡眠呼吸暂停综合征 (OSAS)患者 60例和正常对照组 2 0例进行多导睡眠图检查和 2 4h血压监测。结果 轻度OSAS患者的动态血压及其昼夜节律的改变与正常对照组相比无显著性差异 ;中度OSAS患者的nMDP及血压昼夜节律与正常对照组相比已有显著性差异 ;而重度OSAS组的动态血压改变则更加明显 ,2 4hMDP、2 4hMAP、dMSP、dMDP、dMAP、nMSP、nMDP、nMAP均明显高于对照组 ,其中 2 4hMDP、dMDP、dMAP、nMSP、nMDP与轻、中度组比较有显著性差异 ,同时夜间血压下降节律紊乱 ,昼夜血压差值减小。OSAS患者 2 4hMDP、dMDP、nMSP、nMDP、nMAP与睡眠呼吸暂停低通气指数 (AHI)呈显著正相关 ,而 2 4hMSP、2 4hMAP、nMSP、nMAP、ΔSBP、ΔDBP与睡眠中经皮血氧饱和度(SpO2 )降低大于 0 0 4的总次数、SpO2 低于 0 90的时间均呈正相关 ,而与睡眠中SpO2 最低值、SpO2 平均值呈负相关。结论 OSAS患者各期血压的平均水平与AHI、呼吸暂停持续时间及SpO2 降低的程度显著相关 ,OSAS的病情越重 ,这种血压变化及昼夜节律改变越显著
Objective To investigate the effect of nocturnal hypoxemia on ambulatory blood pressure changes in obstructive sleep apnea (OSA). Methods 60 patients with obstructive sleep apnea syndrome (OSAS) and 20 normal controls were selected for polysomnography and 24 hours blood pressure monitoring. Results There was no significant difference in ambulatory blood pressure and circadian rhythm between patients with mild OSAS and normal control group. The nMDP and the circadian rhythm of blood pressure in patients with moderate OSAS had significant differences compared with the normal control group. 24 hMDP, 24 hMAP, dMSP, dMDP, dMAP, nMSP, nMDP, nMAP were significantly higher than the control group, of which 24 hMDP, dMDP, dMAP, nMSP, nMDP and light and moderate groups Compared with significant differences, while nocturnal decline in blood pressure disorders, diurnal blood pressure difference decreased. There was a significant positive correlation between 24 hMDP, nMSP, nMDP, nMAP and sleep apnea-hypopnea index (AHI) in patients with OSAS, and no significant difference was found between 24 hMSP, 24 hMAP, nMSP, nMAP, (SpO2) decreased more than 0 0 4 total number of times, SpO2 less than 0 90 the time was positively correlated with sleep SpO2 lowest value, SpO2 mean negatively correlated. Conclusions The average blood pressure in each stage of OSAS is significantly correlated with the duration of AHI, the duration of apnea and the degree of SpO2 reduction. The more severe the OSAS, the more significant the change of blood pressure and circadian rhythm