摘要
目的探讨高血压合并阻塞性睡眠呼吸暂停综合征(OSAS)患者的代谢特点。方法随机选择住院的原发性高血压(EH)患者550例,其中男418例,女132例,根据睡眠呼吸暂停及呼吸紊乱指数(AHI)分成4组:单纯EH组94例(Ⅰ组),轻度OSAS+EH组157例(Ⅱ组),中度OSAS+EH组126例(Ⅲ组),重度OSAS+EH组173例(Ⅳ组)。所有患者均测量呼吸紊乱指数、身高、体质量、血压、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油、空腹血糖、餐后2 h血糖(2hPG)、空腹胰岛素(FINS)、餐后2 h胰岛素(2hPINS)、尿酸和同型半胱氨酸(Hcy)水平。结果重度OSAS+EH组的年龄、BMI[(29.9±3.7)比(27.5±2.9)kg/m2]、AHI、FINS和尿酸水平[(374.1±92.2)比(342.1±91.0)μmol/L]高于单纯EH组(P<0.05)。重度OSAS+EH组的HDL-C、最低血氧饱和度(MSpO2)[(69.9±11.8)%比(85.0±10.3)%,P<0.05]低于单纯EH组。重度OSAS+EH组的2hPINS高于轻度OSAS+EH组、中度OSAS+EH组(P<0.05)。低HDL-C、代谢综合征、高尿酸发生率随着阻塞程度的加重而增加(P<0.05)。具有2和3项代谢指标异常的发生率在各组之间差异有统计学意义(P<0.05)。结论代谢性疾病在高血压合并OSAS时具有升高的趋势,且随着阻塞程度加重而发生率增加。
Objective obstructive sleep apnea syndrome（OSAS） is a well-recognized risk factor for cardiovascular disorders and is related to metabolic syndrome.The aim of this study was to investigate the characteristics of metabolism in hypertensive patients with OSAS.Methods Five hundred fifty patients were enrolled.The subjects underwent polysomnography.According to apnea-hypopnea index（AHI）,the patients were divided into four groups.Ninety-four essential hypertension（EH） only patients served as control.There were 157 patients in mild,126 in moderate and 173 in severe OSAS＋EH group.AHI,body mass index（BMI）,blood pressure,fasting serum total cholesterol（TC）,HDL-C,LDL-C,triglycerides（TG）,glucose（G）,insulin（INS）,uric acid（UA） and homocysteine（Hcy） were examined.Results Patients in OSAS＋EH groups were older,had higher levels of BMI [（29.9±3.7） vs（27.5±2.9）kg/m2],AHI,FINS and UA [（374.1±92.2） vs（342.1±91.0）μmol/L] than those in control（P〈0.05）.Patients in severe OSAS＋EH group had lower levels of HDL-C,MSpO2 [（69.9±11.8）% vs（85.0±10.3）%,P〈0.05] than those in control.Patients in severe OSAS＋EH group had higher levels of 2HPINS than those in mild and moderate group （P〈0.05）.The levels of TG,HDL-C,MS,UA in severe OSAS＋EH were higher than in EH.UA in OSAS＋EH was higher than in EH.There were significant differences in two or three measures among the four groups.Conclusion Hypertensive patients with severe OSAS have more metabolic disfunctions.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2011年第9期847-850,共4页
Chinese Journal of Hypertension
基金
环境代谢因素通过炎症免疫通路启动高血压发生的机制[2012CB517802](973项目)
关键词
阻塞性睡眠呼吸暂停
高血压
代谢
Obstructive sleep apnea-hypopnean
Hypertension
Metabolic
