阻塞性睡眠呼吸暂停低通气综合征病情程度与高血压的关系

摘要

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病情程度与伴发高血压比率的关系.方法 选取1999年1月至2011年6月行睡眠监测的1149例中年患者,年龄≥45岁,且＜ 65岁.分析呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、体质量指数(BMI)与高血压的相关性.将患者按AHI分为10个组,组1为单纯鼾症组(AHI＜5次/h),组2～10为OSAHS患者组,组2为轻度组(5次/h≤AHI＜ 15次/h),组3为中度组(15次/h≤AHI＜ 30次/h),组4以上为重度组,其中组4为30次/h≤AHI＜ 40次/h,组5为40次/h≤AHI＜ 50次/h,组6为50次/h≤AHI＜60次/h,组7为60次/h≤AHI＜ 70次/h,组8为70次/h≤AHI＜ 80次/h,组9为80次/h≤AHI＜90次/h,组10为AHI≥ 90次/h.分别统计各组OSAHS伴发高血压的例数,并进行列联表分析.结果 1149例患者中1004例确诊为OSAHS,行相关性分析显示AHI与收缩压、舒张压呈正相关趋势(r值分别为0.239、0.305,P值均＜0.01)；回归分析显示AHI是高血压的独立危险因素(P ＜0.001).组1与组2、3,组4和组5,组6至组10之间伴发高血压比率差异无统计学意义(x2值分别为3.821、0.005、1.325,P值均＞0.05).组4与组1、2、3,组5和组6之间伴发高血压比率差异有统计学意义(x2值分别为12.615、4.300,P值均＜0.05),伴发高血压比率在AHI 30次/h和50次/h呈现2个明显截点.结论 随着OSAHS病情程度加重,伴发高血压比率呈上升趋势.%Objective To explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension.Methods There were 1149 middle aged patients who were suspected to have OSAHS underwent polysomnography (PSG) from Jan,1999 to June,2011.The age of the patients ranged from 45 to 65 years. The patients were divided into 10 groups according to sleep apnea hypopnea index (AHI),group 1:AHI ＜5; group 2:5≤AHI ＜ 15; group 3:15≤AHI ＜30; group 4:30≤AHI ＜40 ; group 5:40 ≤ AHI ＜ 50 ; group 6:50 ≤ AHI ＜ 60 ; group 7:60 ≤ AHI ＜ 70 ; group 8:70 ≤ AHI ＜ 80 ;group 9:80 ≤ AHI ＜ 90; group 10:AHI ≥90.The incidence of hypertension in each group was tested using crosstabs method.The correlation between AHI,lowest oxygen saturation (LSaO2 ),age,body mass index (BMI) and hypertension were analyzed.Results Among 1149 suspected OSAHS patients,1004 were diagnosed as OSAHS by PSG.There were positive correlation between AHI and diastolic,systolic blood pressure ( r were 0.239 and 0.305,respectively,P ＜ 0.01 ). AHI was independent risk factor of hypertension(P ＜0.001 ).No statistically significant difference in the incidence of hypertension was found among group 1 and group 2,3,group 4 and group 5,group 6 to group 10 ( x2 were 3.821,0.005 and 1.325,P ＞ 0.05,respectively).There was significant difference in the incidence of hypertension among group 4 and group 1,2,3,group 5 and group 6 ( x2 were 2.615 and 4.300,P ＜0.05,respectively).There were two cutoff points at the AHI of 30 and 50.Conclusion With OSAHS exacerbations,the incidence of hypertension was significantly increased.