睡眠呼吸暂停相关性高血压颈动脉硬化的危险因素.pdfVIP

睡眠呼吸暂停相关性高血压颈动脉硬化的 危险因素 程维平 李南方 严治涛 洪静 汪迎春 李涛 目的 调查睡眠呼吸暂停相关性高血压中颈动脉粥样硬化及不稳定斑块的患病率及 影响因素。方法 603例诊断为睡眠呼吸暂停相关性高血压入选病例组，根据睡眠呼吸紊乱指数 (AHI)进一步分为轻 （AHI5～15）、中(AHI15～30)、重(AHI≥30)3组，AHI＜5者为对照组。根据 颈动脉超声判断斑块性质。结果 4组间性别不匹配；颈动脉粥样硬化在中、重度组高于对照组 (P＜0.01)，不稳定斑块在组间无差异；对该人群颈动脉粥样硬化可能的危险因素进行因子分析，共 提取6个公因子，以各因子得分为因变量进入逐步logistic回归，提示阻塞性睡眠呼吸暂停、血脂 (TC、LDL-C)为颈动脉粥样硬化的危险因素，OR分别为1.36(95％ CI1.15～1.59)、1.31(95％ CI 1.12～1.54),血脂为不稳定斑块的危险因素，OR为1.30(95％ CI1.06～ 1.58)。结论 睡眠呼吸暂 停相关性高血压中颈动脉粥样硬化可能与阻塞性睡眠呼吸暂停独立相关，而不稳定斑块形成则主要 与脂代谢紊乱有关。 睡眠呼吸暂停，阻塞性；高血压；动脉硬化 Theriskfactorsofcarotidatherosclerosisinsleepapnea-relatedhypertension CHENGWei-ping LINan-fangYANZhi-taoHONGJingWANGYing-chunLITao CenterofHypertension,Peoples HospitalofXin-JiangUygurAutonomousRegion,HypertensionResearchInstituteofXinjiang,Urumqi 830001,China Objective Toinvestigatetheriskfactorsandmorbidityofcarotidatherosclerosis(CA) andunstableplagueinpatientswithsleepapnea-relatedhypertension(SA-RH).Methods Atotalof603 SA-RHsubjectsscreenedbypolysomnographyaccordingtoapneahypopneaindex(AHI)wererecruitedand dividedinto3groups:mild(AHI5-15),moderate(AHI15-30)andsevere(AHI≥ 30)group,with hypertensivepatientswithAHIlessthan5servedascontrol.CAwasdeterminedbydopplerultrasoundas formationofplaqueand/orintima-mediathicknessmorethan0.9mm.Unstableatheromaplaque(UAP) wasdefinedaslowechoplaqueand/oradmixingechoplaque. Results Gender,age,BMIandblood pressurewerenotmatchedamonggroups.TheprevalenceofCAincreasedinmoderateandsevereSA-RH thanthatincontrol(P＜ 0.01)withnosignificantdifferenceforUAPamonggroups.Factoranalysiswas performedtoextractedcommonfactorsthatmayinfluenceCAandUAP,suchasfactor1-6,represent obstructivesleepapnea(OSA),dyslipidemia(TC,LDL),BMI,bloodpressure,ageanddurationof diseaseanddyslipidemia(TG,HDL)respectively.Logi