阻塞性睡眠呼吸暂停低通气综合征血压变化的相关性研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的血压变化及其相关因素。方法对206例睡眠打鼾患者行多导睡眠图（PSG）监测，其中OSAHS168例，单纯打鼾患者38例，同时对30例无睡眠打鼾者作为正常对照组行PSG检测，分别观测各组睡前、晨起血压变化，同时对OSAHS组晨起舒张压与呼吸暂停指数、低通气指数、睡眠呼吸暂停低通气指数（AHI）、夜间最低血氧饱和度（sa02）、夜间平均SaO：、SaO：低于90％时间（T90）相关性进行分析。结果正常对照组及单纯鼾症组相比睡前、晨起血压变化不明显；OSAHS各组睡前、晨起收缩压变化不明显，而舒张压晨起较睡前明显升高，晨起舒张压变化与呼吸暂停指数、低通气指数、AHI、190成正相关，与夜间最低SaO2成负相关。结论OSAHS患者血压变化主要以舒张压升高为主，睡眠呼吸紊乱对于OSAHS血压升高有着重要的意义，OSAHS可能为高血压发病的独立危险因素之一。

Study on the correlation between obstructive sleep apnea-hypopnea syndrome and blood pressure

Objective To study the change of blood pressure （BP）in patients with obstructive sleep apnea- hypopnea syndrome （OSAHS）, and explore the relationship between OSAHS and BP. Methods Two hundred and six sleep snoring patients （ 168 OSAHS and 38 simple snoring） ,and 30 healthy persons were enrolled. All subjects were tested polysomnography （PSG） and BP. BP was recorded and compared among the simple snoring and OSAHS and healthy persons, and the correlations were analyzed between hypopnea index （HI）, apnea index （AI）, apnea/hyponea index（AHI）, minimal oxygen saturation （SaO2） during sleep, average SaO2 during sleep and total sleep time of SaO2 〈 90% （T90） and the morning diastolic blood pressure （DPB）. Results The blood pressure before sleep and that in the morning between control and simple snoring groups showed no significant difference. The morning DBP was significantly higher than that before sleep in OSAHS group,but systolic blood pressure（SBP） showed no significant difference. The morning DBP was positively correlated with HI, AI, AHI, average SaO2 during sleep and T90, but neg- atively with minimal SaO2 during sleep. Conclusion OSAHS is an independent risk factor for hypertension. Turbu- lence of sleep-disordered breathing may be the major pathogeny of hypertension in OSAHS patients.