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目的观察不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者血压水平及血压变异性特征。方法 62例高血压患者,采用多导睡眠呼吸监测仪监测,根据监测结果将患者分为单纯高血压组(17例)、轻度OSAHS合并高血压组(17例)、中度OSAHS合并高血压组(12例)、重度OSAHS合并高血压组(16例),比较四组白天、夜晚平均血压水平及动态血压变异性情况。结果重度OSAHS合并高血压组白天收缩压(SBP)为(143.8±13.6)mm Hg(1 mm Hg=0.133 k Pa),舒张压(DBP)为(99.4±8.7)mm Hg,夜晚SBP为(135.6±12.7)mm Hg,DBP为(90.2±8.4)mm Hg;单纯高血压组白天SBP为(130.3±10.5)mm Hg,DBP为(91.5±8.2)mm Hg,夜晚SBP为(124.0±10.5)mm Hg,DBP为(83.8±7.2)mm Hg;重度OSAHS合并高血压组患者白天、夜晚的平均血压水平显著高于单纯高血压组,差异有统计学意义(P<0.05)。轻度、中度OSAHS合并高血压组患者与单纯高血压组白天、夜晚的平均血压水平比较差异无统计学意义(P>0.05)。重度OSAHS合并高血压组患者的血压变异性明显高于单纯高血压组,差异有统计学意义(P<0.05)。结论重度OSAHS合并高血压患者其全天血压水平都有显著提高,血压变异性显著增加。
Objective To observe the changes of blood pressure and blood pressure variability in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) complicated with hypertension. Methods Sixty-two hypertensive patients were monitored by polysomnography. According to the monitoring results, the patients were divided into simple hypertension group (17 cases), mild OSAHS combined hypertension group (17 cases), moderate OSAHS with hypertension (N = 12) and severe OSAHS with hypertension (n = 16). The mean daytime and nighttime blood pressure and ambulatory blood pressure variability were compared between the four groups. Results SBP was (143.8 ± 13.6) mm Hg (1 mm Hg = 0.133 kPa), diastolic blood pressure (DBP) was (99.4 ± 8.7) mm Hg, and SBP was (135.6 SBP was (130.3 ± 10.5) mm Hg, DBP was (91.5 ± 8.2) mm Hg, nighttime SBP was (124.0 ± 10.5) mm Hg and DBP was (83.8 ± 7.2) mm Hg. The mean blood pressure at daytime and night in patients with severe OSAHS complicated with hypertension was significantly higher than that in patients with hypertension alone (P <0.05). There was no significant difference in average blood pressure between mild and moderate OSAHS patients with hypertension and those with hypertension only daytime and nighttime (P> 0.05). The blood pressure variability of patients with OSAHS complicated with hypertension was significantly higher than that of patients with hypertension only (P <0.05). Conclusion Severe OSAHS patients with hypertension have a significant increase in blood pressure levels throughout the day, with a significant increase in variability of blood pressure.