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目的研究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)对于短期进驻高原地区驻训的高血压Ⅰ级青年官兵血压的影响,并分析其机制。方法试验组测定9名高血压Ⅰ级并发OSAHS青年官兵的基础血压和高原驻训期间(10,30和60 d)血压、心率,并采集相应时间点外周血氧饱和度(SO2)、睡眠时间、睡眠呼吸暂停低通气指数(apnea-hypopnea index,AHI)、神经内分泌激素[肾素-血管紧张-醛固酮系统(RAAS)、皮质醇];对照组测定4名高血压Ⅰ级无OSAHS青年官兵的基础血压和高原驻训期间(10,30和60 d)血压、心率,并采集相应时间点SO2、睡眠时间、AHI、神经内分泌激素(RAAS、皮质醇)。结果试验组官兵进驻高原后收缩压和舒张压均较基线水平显著升高(P<0.05),以舒张压升高为主。SO2下降显著(P<0.05),睡眠时间显著缩短(P<0.05),AHI显著增加(P<0.05),神经内分泌激素水平(RAAS及皮质醇)显著升高(P<0.05)。对照组官兵进驻高原前后血压、外周血SO2、睡眠时间、AHI及神经内分泌激素均无显著差异。结论高原地区可导致高血压Ⅰ级的青年患者短时间血压持续升高,其机制可能与OSAHS引起血SO2下降、睡眠时间缩短、AHI增加及神经内分泌系统激活相关。
Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on the blood pressure of grade I young men and women stationed in high altitude in the plateau area and to analyze their mechanism. Methods Blood pressure and heart rate were measured in 9 hypertensive I-stage patients with OSAHS, and the blood pressure and heart rate were measured during the training period (10, 30 and 60 days). The peripheral oxygen saturation (SO2), sleep time , Apnea-hypopnea index (AHI), neuroendocrine hormone [renin-angiotensin-aldosterone system (RAAS), cortisol]. The control group was divided into four groups: Baseline blood pressure and blood pressure and heart rate during the training period (10, 30 and 60 days) were observed. SO2, sleep time, AHI, and neuroendocrine hormones (RAAS, Cortisol) were collected at the corresponding time points. Results After the officers and men stationed in plateau, the systolic and diastolic blood pressure of the experimental group were significantly higher than those of the baseline (P <0.05), and the diastolic blood pressure was the main factor. SO2 decreased significantly (P <0.05), sleep time significantly shortened (P <0.05), AHI increased significantly (P <0.05), and neuroendocrine hormone levels (RAAS and cortisol) increased significantly (P <0.05). Blood pressure, peripheral blood SO2, sleep time, AHI and neuroendocrine hormones in the control group were not significantly different before and after entering the plateau. CONCLUSIONS: Short-term blood pressure in young patients with grade Ⅰ hypertension may continue to increase in the plateau. The mechanism may be related to the decline of blood SO2, the shortened sleep time, the increase of AHI and the activation of neuroendocrine system in patients with OSAHS.