短期持续正压通气治疗对不同性别OSAHS合并高血压患者降压疗效的比较

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目的探讨短期持续正压通气(CPAP)治疗对不同性别阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)合并高血压患者降压疗效的差异。方法入选2012年11月—2013年5月在新疆维吾尔自治区人民医院高血压科且经多导睡眠监测确诊的OSAHS合并高血压住院患者100例,按性别分为男性组与女性组,在原有降压药物治疗基础上,给予连续每日夜间CPAP治疗(>6 h/晚)1周,监测每日血压水平,治疗前后血压及血压达标率做组内自身前后对照比较,治疗前后血压差值(下降幅度)行组间比较。结果1男性CPAP治疗第7日晨起平均动脉压[(103.4±10.4)mm Hg vs.(113.4±11.7)mm Hg(P<0.05),1mm Hg=0.133 k Pa]低于治疗前;女性治疗前后血压差异无统计学意义(P>0.05);男性第7日晨起平均动脉压下降幅度[(10.1±12.5)mm Hg vs.(1.7±6.7)mm Hg,P<0.05]大于女性。2男性CPAP治疗第7日晨起收缩压达标率[79.0%vs.43.2%(P<0.05)]、晨起舒张压达标率[79.0%vs.28.4%(P<0.05)]高于治疗前;女性仅晨起舒张压达标率[89.5%vs.57.8%(P<0.05)]高于治疗前。结论短期CPAP治疗对男性患者降压疗效优于女性,临床诊治过程中应根据不同性别特点区别对待。 Objective To investigate the effect of short-term continuous positive pressure ventilation (CPAP) on the antihypertensive efficacy in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension. Methods One hundred and ten hospitalized patients with OSAHS complicated with hypertension confirmed by polysomnography in the hypertension department of People’s Hospital of Xinjiang Uygur Autonomous Region from November 2012 to May 2013 were divided into male group and female group by sex, On the basis of the drug treatment, continuous daily nighttime CPAP treatment (> 6 h / night) was given for 1 week, daily blood pressure level was monitored, blood pressure and blood pressure compliance rate before and after treatment were compared before and after the group itself, before and after treatment, blood pressure difference Drop rate) line group comparison. Results 1 Mean arterial pressure of male CPAP patients on the 7th day [(103.4 ± 10.4) mm Hg vs. (113.4 ± 11.7) mm Hg (P <0.05), 1 mm Hg = 0.133 kPa] There was no significant difference in blood pressure between before and after treatment (P> 0.05). The mean arterial blood pressure decrease in the male on the 7th day [(10.1 ± 12.5) mm Hg vs. (1.7 ± 6.7) mm Hg, P <0.05] The systolic blood pressure compliance rate was significantly higher in the 2 male CPAP patients on the 7th day (79.0% vs.43.2%, P <0.05), and the systolic blood pressure compliance rate was 79.0% vs.28.4% (P <0.05) ; Women achieved only the first diastolic blood pressure compliance rate [89.5% vs.57.8% (P <0.05)] higher than before treatment. Conclusion Short-term CPAP treatment of male patients with antihypertensive effect is better than that of women, the clinical diagnosis and treatment should be based on different gender characteristics of different treatment.
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