OSAHS患者夜间血压影响因素分析.docVIP

OSAHS患者夜间血压影响因素分析 　　【摘要】 目的：探讨OSAHS患者夜间低氧血症与血压波动之间的关系。方法：选取经PSG确诊为OSAHS的成年患者，同期行夜间动态血压监测检查，分析和比较各PSG指标与OSAHS患者高血压合并症及患者夜间血压波动的关系。结果：63例入选病例中，高血压合并症患病率42.9%；BMI与氧减饱和度事件累积时间占总睡眠时间的百分比（DT）是OSAHS患者高血压合并症患病率的独立影响因素（P0.05）。DT与NREM%是OSAHS患者夜间舒张压差增大的危险因素（均P0.05）。BMI是夜间血压基础水平的独立危险因素（P0.05）。结论：肥胖、夜间低氧事件持续时间长及睡眠结构中NREM期睡眠占比较多的OSAHS患者需警惕高血压合并症的发生发展。 　　【关键词】 阻塞性睡眠呼吸暂停； 多导睡眠监测； 血氧饱和度； 高血压 　　中图分类号 R56 文献标识码 A 文章编号 1674-6805（2015）4-0010-03 　　Influencing Factors for Nocturnal Blood Pressure of OSAHS Patients/ZENG Yu-hui，CHAI Li-ping，LIANG Jian-gang.//Chinese and Foreign Medical Research，2015，13（4）：10-12 　　【Abstract】 Objective：To explore the relationship between polysomnography（PSG） findings and nocturnal blood pressure，and find out a predictable index for hypertension comorbidity associated with obstructive sleep apnea hypopnea syndrome（OSAHS）.Method：63 patents with a diagnosis of OSAHS did the PSG concurrently with nocturnal ambulatory blood pressure monitor in lab.Regression analysis was applied to evaluate the relationship between PSG data and nocturnal blood pressure data.Result：The morbidity of hypertension in OSAHS patients was 42.9%.BMI was an independent influencing factor of the nocturnal basal blood pressure level（P0.05）.DT and NREM% were the risk factors of nocturnal variation in diastolic pressure（P0.05）.Conclusion：BMI mainly determines the baseline of nocturnal blood pressure，while nocturnal duration of hypoxemia and sleep structure disturbance mainly affect the nocturnal diastolic pressure fluctuation.OSA patients with obesity，higher DT or NREM% in the PSG should be alerted to the potential of having hypertension comorbidity. 　　【Key words】 Obstructive sleep apnea； Polysomnography； Oxyhemoglobin saturation； Hypertension 　　First-author’s address：The Central Hospital in Panyu District of Guangzhou City，Guangzhou 511400，China 　　doi：10.14033/j.cnki.cfmr.2015.04.005 　　阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是临床上最常见的睡眠呼吸障碍之一，并可导致高血压、冠心病、2型糖尿病等多器官多系统损害[1-2]。笔者通过对OSAHS患者的多导睡眠图及同步夜间无创动态