摘要
目的探讨觉醒阈值(ArTH)与阻塞性睡眠呼吸暂停(OSA)患者高血压发生的相关性。方法回顾性收集2020年1月至2021年8月于苏州大学附属第二医院睡眠中心确诊为OSA的患者648例,其中男569例,女79例,年龄42(35,52)岁。收集所有患者的基本信息、临床资料,完成血压测量、相关量表评估,进行夜间多导睡眠监测(PSG)。采用以睡眠呼吸暂停低通气指数(AHI)、最低脉搏血氧饱和度(LSpO_(2))及低通气呼吸事件比例(F_(Hypopneas))作为评分标准的临床预测模型来判断OSA患者的觉醒阈值。根据是否合并高血压将所有患者分为单纯OSA组和OSA合并高血压组,比较上述指标在两组间的差异,并通过二元logistic逐步回归分析探讨OSA患者觉醒阈值与合并高血压的关系。结果648例OSA患者中,OSA合并高血压组415例,单纯OSA组233例。与单纯OSA组相比,OSA合并高血压组的年龄、体重指数、睡前及醒后血压值更大,AHI更高,F_(Hypopneas)更低,差异均有统计学意义(均P<0.05),其他一般资料、PSG参数差异均无统计学意义(均P>0.05);OSA合并高血压组中低觉醒阈值的三条评分标准,即AHI<30次/h、LSpO_(2)>82.5%、F_(Hypopneas)>58.3%的患者比例均更低(均P<0.05),低觉醒阈值患者比例明显更少(30.1%比52.4%,P<0.001);经二元logistic逐步回归分析显示,高觉醒阈值(OR=1.930,95%CI:1.326~2.808,P=0.001)是OSA合并高血压的独立危险因素。结论觉醒阈值在OSA发生高血压中起一定作用,高觉醒阈值的OSA患者发生高血压的风险增高。
Objective To investigate the relationship between arousal threshold(ArTH)and hypertension in patients with obstructive sleep apnea hypopnea syndrome(OSA).Methods This study recruited 648 patients diagnosed with OSA at the Sleep Center of the Second Affiliated Hospital of Soochow University from January 2020 to August 2021,including 569 males and 79 females,aged 42(35,52)years.The basic demographic information and clinical data of all patients were collected,including blood pressure measurement,and relevant questionnaire scores,and nocturnal polysomnography(PSG)parameters.A clinical predictive model based on sleep apnea hypopnea index(AHI),lowest pulse oxygen saturation(LSpaO_(2))and hypopnea ratio(F_(Hypopneas))was used to access the arousal threshold of OSA patients.Patients were divided into OSA group and OSA with hypertension group according to whether they were combined with hypertension.The differences in the above indexes between the two groups were analyzed to explore the relationship between arousal threshold and hypertension in OSA patients,using a binary logistic stepwise regression analysis.Results A total of 648 OSA patients were enrolled,including 415 in the OSA with hypertension group and 233 in the OSA group.Compared with OSA group,OSA with hypertension group had older age,higher body mass index(BMI),higher blood pressure at bedtime and at awakening,higher AHI and lower proportion of hypopnea(all P<0.05).There were no significant differences between other general data and PSG parameters(all P>0.05).The proportion of patients with low arousal threshold(AHI<30 events per hour,LSpO_(2)>82.5%,Fhypopneas>58.3%)in OSA with hypertension group was lower,and the proportion of phenotypic patients with low arousal threshold was significantly lower(30.1%vs.52.4%P<0.001).Binary logistic stepwise regression analysis showed that the high arousal threshold(OR=1.930,95%CI:1.326-2.808,P=0.001)was an independent risk factor for OSA complicated with hypertension.Conclusion The arousal threshold is associated with the
作者
王欣然
成雅萍
乔佳敏
苏桐
程超虹
杨浩宇
韩菲
陈锐
Wang Xinran;Cheng Yaping;Qiao Jiamin;Su Tong;Cheng Chaohong;Yang Haoyu;Han Fei;Chen Rui(Department of Respiratory and Critical Care Medicine/Sleep Center,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China)
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2024年第7期647-653,共7页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
国家自然科学基金(81770085,82070095)
苏州市科技发展计划新型临床诊疗技术(SKY2023054)。
关键词
睡眠呼吸暂停
阻塞性
高血压
觉醒阈值
病理生理机制
横断面研究
Sleep apnea,obstructive
Hypertension
Arousal threshold
Pathophysiological mechanism
Cross-sectional study
