睡眠呼吸暂停综合征对高血压病患者血压昼夜节律及心率变异性的影响

摘要

Objective To explore the influences of obstructive sleep apnea syndrome ( OSAS ) on circadian rhythm of blood pressure ( BP ) and heart rate variability ( HRV ) in hypertensive patients. Methods Hypertensive patients ( n =62 ) were selected and divided into,according to whether or not complicating OSAS, simple group ( without complicating OSAS ) and complicating group ( complicating OSAS ), and other health people ( n = 30 ) were chosen as control group. The differences were compared among three groups in apnea hypopnea index ( AHI ), nocturnal mean blood oxygen level, diurnal and nocturnal BP level, proportion of non-dipper BP curve, HRV frequency domain index ( SDNN and PNN50 ) and time domain index ( low frequency spectrum and high frequency spectrum ). Results The differences between complicating group and the other two groups were all significant greatly and statistically in nocturnal mean blood oxygen level, AHI, HRV frequency domain index ( SDNN and PNN50 ) and time domain index ( low frequency spectrum and high frequency spectrum,all P <0. 01 ). The proportion of non-dipper BP curve was significantly higher in complicating group than that in other two groups ( P <0. 01 ). Conclusion OSAS enhances the abnormal of BP circadian rhythm and HRV in hypertensive patients.%目的 探讨阻塞性睡眠呼吸暂停(OSAS)对高血压病患者血压昼夜节律及心率变异性(HRV)的影响.方法 入选62例高血压病患者,根据是否合并OSAS分为:单纯组(无合并OSAS)及合并组(合并OSAS),另选择同期30名健康人群作为对照组.比较三组患者呼吸紊乱指数(AHI)、夜间平均血氧水平、昼间及夜间血压水平、非杓型血压的比例、HRV频域指标(SDNN、PNN50)与时域指标(低频谱、高频谱)的差异.结果 合并组与单纯组、对照患者比较夜间平均血氧水平、AHI、HRV频域指标(SDNN、PNN50)与时域指标(低频谱、高频谱)差异均有显著统计学意义(P均＜0.01);合并组非杓型血压的比例显著高于其他两组,差异有显著统计学意义(P＜0.01).结论 OSAS增加高血压病患者血压昼夜节律异常及心率变异性.