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目的研究妊娠期高血压疾病患者发生阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的关系。方法选取2014年12月-2016年12月在该院就诊的孕妇80例,随机分为3组,27例正常妊娠孕妇为A组,27例轻度妊娠期高血压疾病患者为B组,26例妊娠期高血压疾病合并OSAHS患者为C组。对比3组患者睡眠呼吸、血压、心肺耦合睡眠监测结果、血清炎性细胞因子浓度及分娩的新生儿情况。结果 C组平均血氧饱和度(MSaO_2)、最低血氧饱和度(LSa O_2)明显低于A组、B组;C组通气指数、体重指数明显高于A组、B组;C组24 h、白天、夜晚收缩压及舒张压均明显高于A组、B组;C组睡觉前、睡醒后收缩压与舒张压均明显高于A组、B组;C组睡眠延迟时间、稳定的睡眠比、清醒/梦睡眠等情况均明显短于A组、B组;C组分娩的新生儿中早产儿、低出生体重、新生儿窒息、产后出血、死亡等发生率均明显高于A组、B组;C组白介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、血管内皮黏附分子-1(VCAM-1)各项指标明显高于A组、B组(P<0.05)。结论妊娠期高血压疾病与OSAHS关系密切,对血压及供氧均造成一定影响,并影响胎儿发育健康。
Objective To study the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and patients with hypertensive disorder complicating pregnancy. Methods Eighty pregnant women in our hospital from December 2014 to December 2016 were randomly divided into three groups. 27 pregnant women were in group A, 27 were in group B with mild gestational hypertension, Cases of hypertensive disorders complicating OSAHS pregnancy for the C group. The sleep breathing, blood pressure, cardiopulmonary coupled sleep monitoring results, serum levels of inflammatory cytokines and newborns in childbirth were compared between the three groups. Results The average oxygen saturation (MSaO_2) and the lowest oxygen saturation (LSa O_2) in group C were significantly lower than those in group A and group B. The index of ventilation and body mass index in group C were significantly higher than those in group A and group B. In group C, , Systolic blood pressure and diastolic blood pressure during day and night were significantly higher than those in group A and group B. The systolic and diastolic blood pressure of group C before going to sleep were significantly higher than those of group A and group B. Sleep delay, Sleep ratio, awake / sleep, etc. were significantly shorter than those in group A and group B. The incidence of preterm birth, low birth weight, neonatal asphyxia, postpartum hemorrhage and death in group C was significantly higher than that in group A , Group B; group C, IL-18, TNF-α, hs-CRP and VCAM-1 Indicators were significantly higher than the A group, B group (P <0.05). Conclusion Hypertensive disorders in pregnancy are closely related to OSAHS, which may affect both blood pressure and oxygen supply and affect fetal development.