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目的 认识打鼾患者睡眠时血压的改变 ,初步探讨阻塞性睡眠呼吸暂停综合征 (OSAS)与高血压之间的关系。方法 对 2 6 6例打鼾者进行Autoset诊疗系统监测及睡前、醒后肘部血压测定 ,16 6例诊断为OSAS患者作为OSAS组 ,10 0例未达到诊断标准者作为对照组 ,对两组进行上述各项指标的统计学处理 ,同时对OSAS伴高血压患者治疗 6个月左右 ,重复上述测定。结果 OSAS组睡前血压 (12 8 94± 19 32 /87 46± 12 30 )mmHg至次晨醒后血压 (139 6 6± 19 38/99 6 8± 16 2 8)mmHg明显升高 (P <0 0 1) ,与对照组睡前血压 (116 12± 11 17/78 2 2±10 18)mmHg及醒后血压 (116 76± 15 42 /78 6 6± 10 94)mmHg比较呈显著性升高 (P <0 0 1) ,OSAS组最低SaO2 (6 2 38± 18 2 4) % ,较对照组最低SaO2 (89 46± 7 6 6 ) %显著降低 (P <0 0 1) ,OSAS组有 88例 (5 3% )确诊为高血压病 ,经鼻面罩持续正压通气 (nCPAP)治疗 6个月有 5 2例患者血压明显下降 ,其中 2 7例患者血压恢复正常。结论 OSAS患者的低氧血症可能是相当部分OSAS伴发高血压的发病原因 ,nCPAP治疗有助于此类患者血压的恢复 ,本文对OSAS引起血压升高的机制作了初步探讨。
Objective To understand the changes of blood pressure during sleep in snoring patients and to explore the relationship between obstructive sleep apnea syndrome (OSAS) and hypertension. Methods A total of 266 snorers were examined with Autoset system, elbow blood pressure before going to bed and after awaking, 16 OSAS patients diagnosed as OSAS group, and 100 patients who did not meet the diagnostic criteria as control group. The above indicators for the statistical treatment, while OSAS patients with hypertension treatment of about 6 months, repeat the above determination. Results The blood pressure at bedtime (12 894 ± 19 32/87 46 ± 12 30) mmHg in OSAS group was significantly higher than that in the morning after morning wake up (139 6 6 ± 19 38/99 6 8 ± 16 2 8) mmHg (P < (P <0.01). Compared with the control group, blood pressure before bed (116 12 ± 11 17/78 2 2 ± 10 18) mmHg and wake-up blood pressure (116 76 ± 15 42/78 6 6 ± 10 94) mmHg were significantly increased The lowest SaO2 (62 38 ± 18 2 4)% in the OSAS group was significantly lower than that in the control group (89 46 ± 76 6%) (P 0 01) A total of 88 patients (53%) were diagnosed as having hypertension. Fifty-two patients underwent nCPAP for 6 months. The blood pressure was significantly decreased, of which 27 patients returned to normal. CONCLUSION: Hypoxemia in OSAS patients may be responsible for a considerable part of the pathogenesis of OSAS associated with hypertension. NCPAP treatment may be helpful for the recovery of blood pressure in these patients. In this paper, the mechanism of OSAS-induced hypertension is preliminarily discussed.