摘要
目的探讨高血压（HP）合并阻塞性睡眠呼吸暂停（obstructive sleep apnea,OSA）患者持续正压通气（CPAP）治疗前后血压昼夜节律的变化。方法选择2011年8月~2015年2月于南京市鼓楼医院集团仪征医院治疗的HP合并OSA患者60例。CPAP治疗前后行24 h动态血压监测,比较患者治疗前后睡眠呼吸暂停低通气指数（AHI）、最低血氧饱和度（Sa O_2）、平均Sa O_2、24 h平均舒张压（24h DBP）,24 h平均收缩压（24 h SBP）,白天平均舒张压（d DBP）,白天平均收缩压（d SBP）,夜间平均舒张压（n DBP）,夜间平均收缩压（n SBP）。结果治疗前,AHI、最低Sa O_2和平均Sa O_2分别为（45.2±10.8）次/h、（78.2±1.3）%和（91.2±1.5）%;治疗后为（28.3±8.6）次/h、（85.4±3.2）%和（93.7±1.6）%,治疗后与治疗前相比AHI下降,最低Sa O_2和平均Sa O_2升高,差异具有统计学意义（P均〈0.05）。治疗后,患者的24 h SBP、24 h DBP、d SBP、d DBP、n SBP及n DBP值均低于治疗前,差异有统计学意义（P均〈0.05）。结论高血压合并阻塞性睡眠呼吸暂停患者存在血压昼夜变化异常,CPAP治疗可改善患者睡眠质量和血压。
Objective To observe and explore the changes of blood pressure circadian rhythm before and after CPAP treatment in patients with Hypertensive（HP） patients combine with obstructive sleep apnea（OSA）. Methods60 HP patients combine with OSA from August 2011 to February 2015 in Yizheng hospital were selected. The 24 h ambulatory blood pressure were monitored before and after CPAP treatment, sleep apnea hypopnea index（AHI）, the lowest oxygen saturation（Sa O_2）, average mean blood pressure Sa O_2, 24 h average blood pressure（24h DBP, 24 h SBP）, daytime average blood pressure（d SBP, d DBP）, night average blood pressure（n SBP, n DBP） were recorded. ResultsBefore treatment, AHI, minimum Sa O_2 and mean Sa O_2 were（45.2±10.8） Times/h,（78.2±1.3） % and（91.2±1.5）%. After treatment, these three indicators were（28.3±8.6） /h,（85.4±3.2） % and（93.7±1.6） %, respectively. Statistically significant difference was observed（P〈0. 05）. After treatment, the patient＇s 24 h SBP, 24 h DBP, d SBP, d DBP, n SBP and n DBP values were lower than before, the difference was statistically significant（P〈0. 05）. Conclusion CPAP therapy can not only improve sleep quality, but also reduce the proportion of patients with nondipper blood pressure in patients with HP combine OSA.
出处
《中国循证心血管医学杂志》
2016年第2期172-174,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
无锡市卫生局科研立项项目(MS201535)
