慢性顽固性失眠合并高血压临床特点分析

目的：探讨慢性顽固定失眠合并高血压患者的睡眠及血压变化特征,为临床治疗提供参考。方法：回顾性分析2009年4月-2012年5月本院脑病科收治的90例慢性失眠伴高血压患者的临床资料,按照降压药服用情况分为三组（A、B、C组）,每组各30例。另选择同期健康门诊体检者30例作为对照组（D组）。全部对象接受多导睡眠监测、24 h动态血压监测,记录入院时催眠镇静药物的应用情况及各组睡眠、血压的变化。结果：镇静催眠药的应用率随着高血压的加重而不断升高,各组镇静催眠药的应用率比较差异有统计学意义（P〈0.01）;与D组相比,其他组PSQI总分增加（P〈0.05）,睡眠潜伏时间、觉醒时间均有明显延长（P〈0.05）,睡眠效率显著下降（P〈0.01）;A、B、C三组白天及夜晚SBP、DBP均显著高于D组（P〈0.05）,ΔSBP、ΔDBP明显低于D组（P〈0.05）。结论：睡眠障碍的加剧与血压的升高有关,而失眠会影响血压的节律性变化。

Clinical Characteristics of Chronic Intractable Insomnia Combined with Hypereension

Objective：To analyze the clinical characteristics of hypertension with chronic intractable insomnia,to observe the change of PSQI and blood pressure.Method：Clinical date of 90 cases with hypertension and chronic intractable insomnia were retrospectively analyzed from April 2009 to May 2012,all the patients were divided into three groups（group A,B,C） according to the antihypertensive use situation,each group had 30 cases.In addition,30 health check-up people were selected as a control group.All participants were underwent polysomnography recorded and ambulatory blood pressure monitoring to evaluate the change of sleep and blood pressure.Result：The sedative hypnotics use rate was increased with the rise of blood pressure,the use rate among groups had significant difference（P0.01）;Compared with the group D,all the patients＇ PQSI were increased（P〈0.05）;sleep latency time,wake after sleep onset also enhanced（P〈0.05）;sleep efficiency descended（P〈0.01）;day and night SBP,DBP in the group A,B,C were significantly higher than that of the group D（P〈0.05）;ΔSBP,ΔDBP were Significantly lower than the group D（P〈0.05）.Conclusion：Sleep disorders is related to the blood pressure,and it has an impact on the rhythmic change of blood pressure.