顽固性高血压合并阻塞性睡眠呼吸暂停综合征的临床特点

摘要

Objective To understand the clinical characteristics of refractory hypertension ( RH ) complicating obstructive sleep apnea syndrome ( OSAS ) through monitoring of polysomnography ( PSG ) and clinical observation in RH patients. Methods RH patients ( n =172 ) were given PSG monitoring and then divided into moderate—severe OSAS group, mild OSAS group and non—OSAS group according to apnea hyponea index ( AHI ) . The clinical changes, ambulatory blood pressure and biochemical indexes were observed in 3 groups. Results Of 172 RH patients, the incidence of moderate—severe OSAS was 56.39%. In moderate—severe OSAS group, the patients were more younger [ ( 47.1 ± 11.8 ) vs. ( 52.3 ± 12.6 ) , P<0.05], body mass index ( BMI ) was higher f ( 28.1 ± 5.8 ) vs. ( 25.1 ± 6.2 ) , P<0.051 and level of hs-CRP was higher [ (2.4 ± 1.98 ) vs. ( 1.34 ± 1.23 ) , P<0.05] compared with other two groups. Conclusion Younger RH patients are easily complicated by moderate—severe OSAS, and at the same time, obesity and higher inflammatory level are major risk factors.%目的 通过对统一性高血压(RH)患者行多导睡眠图(PSG)监测和临床观察,了解RH合并阻塞性睡眠呼吸暂停综合征(OSAS)临床特点.方法 对172例RH进行PSG监测,根据呼吸暂停加低通气指数分成中重度OSAS组、轻度或无OSAS组.观察两组临床情况、动态血压和生化指标等.结果 172例RH患者中中重度OSAS发生率为56.39%,与轻度或无OSAS组患者相比,合并中重度OSAS的患者更年轻化[(47.1±11.8)岁 vs.(52.3±12.6)岁,P＜0.05]、体重指数(BMI)偏高[(28.1±5.8)kg/m2 vs.(25.1±6.2)kg/m2,P＜0.05],同时高敏C反应蛋白更高[(2.4±1.98)mmol/L vs.(1.34±1.23)mmol/L,P＜0.05].结论 年轻的RH患者更易合并中重度OSAS,同时肥胖和体内炎症水平偏高也是中重度OSAS的主要危险因素.