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目的:探讨高血压合并阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)患者血清胱抑素(CysC)的危险因素。方法:83例高血压患者行血生化和多导睡眠仪检测,根据多导睡眠仪的监测结果,符合OSA诊断的41例患者作为高血压合并OSA组,42例单纯高血压患者作为高血压组。结果:(1)高血压合并OSA组的体质量、体质量指数、颈围、腰围、腰臀比、收缩压、夜间缺氧事件总数、夜间缺氧事件总时间、睡眠呼吸暂停低通气指数(AHI)、空腹血糖、餐后2h血糖、CysC、总胆固醇、三酰甘油和低密度脂蛋白胆固醇均高于高血压组(P均<0.05);(2)Pearson相关或Spearman相关分析显示,血清CysC与体质量、颈围、腰围、腰臀比、夜间缺氧事件总数、夜间缺氧事件总时间和AHI呈正相关(P均<005);(3)多元线性逐步回归分析示仅夜间缺氧事件总数(β=0.484,P<0.05)和AHI(β=0.481,P<0.05)与血清CysC的相关性有统计学意义。结论:夜间缺氧事件总数和AHI是高血压合并OSA患者血清CysC的独立危险因素。
Objective: To investigate the risk factors of serum cystatin (CysC) in patients with hypertension and obstructive sleep apnea (OSA). Methods: Totally 83 hypertensive patients underwent blood biochemistry and polysomnography. According to the monitoring results of polysomnography, 41 patients with OSA diagnosed as OSA and 42 as hypertensive patients . Results: (1) Body mass, body mass index, neck circumference, waist circumference, waist-hip ratio, systolic blood pressure, total number of nighttime hypoxia events, total nighttime hypoxia events, sleep apnea-hypopnea index AHI, fasting blood glucose, postprandial blood glucose 2h, CysC, total cholesterol, triglyceride and low density lipoprotein cholesterol were higher than those in hypertension group (all P <0.05). (2) Pearson correlation or Spearman correlation analysis showed that serum CysC was positively correlated with body mass, neck circumference, waist circumference, waist-to-hip ratio, total number of nighttime hypoxia events, total nighttime hypoxia events and AHI (P <0.005); (3) Multiple linear stepwise regression analysis showed that nighttime hypoxia The correlation between total events (β = 0.484, P <0.05) and AHI (β = 0.481, P <0.05) and serum CysC was statistically significant. Conclusions: The number of nighttime hypoxia events and AHI are independent risk factors for serum CysC in patients with hypertension and OSA.