首页> 中文期刊>中国临床医学 >阻塞性睡眠呼吸暂停低通气综合征与高血压的相关性及危险因素分析

阻塞性睡眠呼吸暂停低通气综合征与高血压的相关性及危险因素分析

     

摘要

Objective : To investigate the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS ) and hypertension and its risk factors ,so as to provide basis for prevention and treatment of OSAHS accompanied by hypertension . Methods : A total of 108 OSAHS patients were enrolled and the general conditions were recorded . The blood pressure at 22 ∶ 00 before sleep and that at 8 ∶ 00 . next morning was determined routinely ,and the blood lipid level was detected . According to apnea hypoapnea index (AHI) ,the patients were divided into three groups ,the mild group (5/h ≤ AHI < 15/h) with 31 cases ,the moderate group (15/h ≤ AHI < 40/h) with 36 cases ,and the severe group (AHI ≥ 40 /h) with 41 cases . The levels of blood pressure were compared among the groups . According to whether OSAHS was accompanied by hypertension ,the patients were divided into simple OSAHS group and OSAHS accompanied by hypertension group . The relevant factors associated with OSAHS accompanied by hypertension were screened out by single factor analysis ,and then the multiple Logistic regression analysis was conducted .Results : (1)Among 108 patients with OSAHS ,60 cases(55 .6% ) were accompanied by hypertension ,including 15 cases of mild group(48 .4% ,15/31) ,19 cases of moderate group (52 .8% ,19/36) ,and 26 cases of severe group (63 .4% ,26/41 ) . There was no significant difference regarding the prevalence rate of hypertension among the three groups (P > 0 .05) .There were significant differences regarding systolic blood pressure(SBP) and diastolic blood pressure (DBP) at 22 ∶ 00 and 8 ∶ 00 among the three groups (P < 0 .05) ;SBP and DBP at 22 ∶ 00 and 8 ∶ 00 in severe group were significantly higher than those in mild group (P< 0 .05) .SBP at 22 ∶ 00 and 8 ∶ 00 in severe group was significantly higher than that in moderate group (P< 0 .05) .(2) Single factor analysis showed that age ,body mass index (BMI) ,smoking rate ,abdominal circumference ,AHI ,total cholesterol(TC) ,triglyceride(TG ) and low density lipoprotein cholesterol (LDL-C) in OSAHS accompanied by hypertension group were significantly higher than those in simple OSAHS group ,while HDL-C was significantly lower than that in simple OSAHS group ( P < 0 .05 ) . (3 ) Multivariate Logistic regression analysis showed that BMI ,AHI ,TC were the risk factors for OSAHS accompanied by hypertension .Conclusions :The level of blood pressure in patients with OSAHS was accordance with the disease severity ,while BMI ,AHI ,TC were the risk factors for OSAHS accompanied by hypertension .%目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压的关系及其危险因素,为预防和治疗 OSAHS 合并高血压提供依据。方法:选择 OSAHS 患者共108例,记录一般情况,测定患者22∶00和8∶00的血压,检测血脂水平。根据呼吸暂停低通气指数(AHI)将108例患者分为3组。轻度组:5次/h ≤ AHI <15次/h ,31例;中度组:15次/h ≤ AHI <40次/h ,36例;重度组:AHI ≥40次/h ,41例。比较各组的血压水平。根据 OSAHS 患者是否合并高血压,将患者分为单纯 OSAHS组及 OSAHS 合并高血压组。通过单因素分析筛选与 OSAHS 合并高血压相关的因素,然后进行 Logistic 多因素回归分析。结果:(1)108例 OSAHS 患者中合并高血压60例(55.6%),其中轻度组15例(48.4%,15/31),中度组19例(52.8%,19/36),重度组26例(63.4%,26/41);3组间高血压的患病率差异无统计学意义(P >0.05) 。 3组间22∶00和8∶00的收缩压(SBP)、舒张压(DBP)比较,差异均有统计学意义(P<0.05)。重度组22∶00和8∶00 SBP 、DBP 明显高于轻度组(P<0.05),重度组22∶00和8∶00 SBP 明显高于中度组(P<0.05)。(2)单因素分析结果显示,OSAHS 合并高血压组的年龄、体质量指数(BMI)、吸烟率、腹围、AHI 、总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)均高于单纯 OSAHS 组(P <0.05),而高密度脂蛋白胆固醇(HDL-C)低于单纯 OSAHS 组( P<0.05)。(3)多因素 Logistic 回归结果显示,BMI 、AHI 、TC为 OSAHS 合并高血压的危险因素。结论: OSAHS 患者高血压的水平与其病情严重程度具有一致性,而 BMI 、AHI 、TC 为OSAHS 合并高血压的危险因素。

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