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目的分析高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)患者的临床特点及动态血压。方法将214例轻、中度高血压患者分为四组:单纯高血压组(A组,52例)、高血压合并轻度OSAS组(B组,51例)、高血压合并中度OSAS组(C组,51例)和高血压合并重度OSAS组(D组,60例)。比较四组患者年龄、性别构成比、颈围、BMI、腰臀比(WHR)、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO_2)、白天平均收缩压(dSBP)、白天平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)、血压昼夜节律及晨峰血压值。结果 B、C、D组中、老年男性比例、颈围、WHR、BMI、AHI均高于A组(P<0.01),而LSaO2低于A组(P<0.01)。B、C组dSBP、dDBP较A组差异无统计学意义(P>0.05),仅D组dSBP高于A组(P<0.05)。B、C、D组nSBP、nDBP、血压晨峰值及非勺型比例均高于A组(P<0.05)。结论高血压合并OSAS患者以中老年男性较多,且超重、肥胖者居多;OSAS作为高血压的危险因素,可以加重高血压,与高血压的发展密切相关。
Objective To analyze the clinical features and ambulatory blood pressure in patients with hypertension and obstructive sleep apnea syndrome (OSAS). Methods 214 patients with mild to moderate hypertension were divided into four groups: hypertension group (group A, n = 52), hypertension group with mild OSAS (group B, n = 51), hypertension with moderate OSAS group (Group C, n = 51) and hypertension with severe OSAS (group D, n = 60). Age, sex ratio, neck circumference, BMI, WHR, AHI, LSaO_2, dSBP, daytime average Diastolic blood pressure (dDBP), nocturnal mean systolic blood pressure (nSBP), nighttime mean diastolic blood pressure (nDBP), blood pressure circadian rhythm and morning blood pressure values. Results In the groups B, C and D, the proportion of elderly men, neck circumference, WHR, BMI and AHI were higher than those in group A (P <0.01), while LSaO2 was lower than that in group A (P <0.01). There was no significant difference in dSBP and dDBP between group B and C (P> 0.05), but dSBP in group D was higher than that of group A (P <0.05). The nSBP, nDBP, peak morning blood pressure and non-dipper proportion in group B, C and D were higher than those in group A (P <0.05). Conclusion There are more middle-aged and elderly men with hypertension in OSAS patients, and overweight and obesity are the majority. OSAS as a risk factor for hypertension can aggravate hypertension and is closely related to the development of hypertension.