摘要
目的:分析高血压合并阻塞性睡眠呼吸暂停综合征患者临床治疗前后的血压昼夜节律变化特征。方法:2012年11月-2013年11月收治高血压患者90例,作为研究对象,按照多导睡眠仪监测结果将患者分为单纯高血压组(40例)和高血压合并阻塞性睡眠呼吸暂停综合征组(50例),采用回顾性的方式分析患者的临床资料,并对两组患者治疗前后的血压昼夜节律变化进行对比分析。结果:治疗前单纯高血压组中有14例(35.0%)患者呈非杓型;高血压合并阻塞性睡眠呼吸暂停综合征组中有43例(86.0%)患者呈非杓型,两组昼夜血压呈非杓型的比例比较差异具有统计学意义(P<0.05)。治疗后单纯高血压组中有7例(17.5%)患者呈非杓型;高血压合并阻塞性睡眠呼吸暂停综合征组中有20例(40.0%)患者呈非杓型,两组患者与治疗前比较昼夜血压呈非杓型的比例明显下降(P<0.05),且高血压合并阻塞性睡眠呼吸暂停综合征组患者非杓型血压下降更加显著。结论:高血压患者昼夜血压呈非构型时应考虑合并睡眠呼吸暂停综合征,经积极的治疗可以有效降低昼夜血压呈非杓型的比例。
Objective:To analyze the characteristic of blood pressure circadian rhythm changes before and after clinic treatment of hypertension combined with obstructive sleep apnea syndrome patients.Methods:90 patients with hypertension were selected from November 2012 to November 2013 as the research objects.They were divided into the pure hypertension group(40 cases) and teh hypertension combines with obstructive sleep apnea syndrome group(50 cases) according to the result of polysomnography.The clinical data of patients were retrospectively analyzed.The blood pressure circadian rhythm changes before and after treatment of the two groups were compared and analyzed.Results:Before treatment,14 patients(35.0%) were non configurational in the pure hypertension group.43 patients(86.0%) were non configurational in the hypertension combined with obstructive sleep apnea syndrome group.The proportions of non configurational circadian blood pressure in the two groups were compared.The difference was statistically significant(P<0.05).After treatment,7 patients(17.5%) were non configurational in the pure hypertension group.20 patients(40.0%) were non configurational in the hypertension combined with obstructive sleep apnea syndrome group. Compared with prior treatment,the proportions of non configurational circadian blood pressure in the two groups were obviously decline(P<0.05).The non configurational blood pressure of the hypertension combined with obstructive sleep apnea syndrome group was more remarkably decline.Conclusion:When the circadian blood pressure of patients with hypertension is non configurational,it should consider that the patients with hypertension may be combined with obstructive sleep apnea syndrome. The active treatment can effectively reduce the proportion of non configuration.
关键词
高血压
阻塞性睡眠呼吸暂停综合征
血压
昼夜节律变化
Hypertension
Obstructive sleep apnea syndrome
Blood pressure
Circadian rhythm changes