应用无创通气治疗阻塞性睡眠呼吸暂停低通气综合征合并高血压患者的治疗分析

摘要

目的:探讨无创通气条件下应用持续气道正压通气(CPAP)模式对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者的疗效.方法:将102例阻塞性睡眠呼吸暂停低通气综合征合并高血压患者随机分为两组,每组51例,对照组采取氨氯地平(5mg)联用替米沙坦(80mg)降血压治疗,治疗组在对照组治疗基础上加用持续气道正压通气治疗,分别观察治疗1天、2周及4周后两组血压的变化.结果:两组患者血压均有所下降,但对照组患者夜间血压控制不良.治疗组患者加用正压通气治疗1天、2周及4周后血压逐渐下降,夜间收缩压和舒张压逐渐降低,较对照组明显下降(P<0.05),治疗组总有效率均高于对照组(P<0.05). 结论:合并有OSAHS的高血压患者多为难治性,单纯降压药物治疗效果欠佳,需要同时应用正压通气进行治疗,值得临床推广应用.%Objective:To investigate the therapeutic effects of continuous positive airway pressure(CPAP) on obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension. Methods:Total of 102 cases of obstructive sleep apnea hypopnea syndrome complicated with hypertension were enrolled in the study. They were randomly divided into two groups, 51 cases in each group. The patients in the control group received amlodipine (5mg) combined with telmisartan (80mg) antihypertensive therapy, while the patients in the treatment group received durg antithpertensive therapy and continuous positive airway pressure therapy . Blood pressure of the patients were measured on day 1, day14 and day 28 after treatment. Results:Average blood pressure value of patients in two groups were all decreased, but blood pressure control of patients in the control group during night were relatively poor . On day 1, day14 and day 28 after treatment, blood pressure levels of patients in the treatment group were gradually decreased. As compared with that of the control group, nocturnal systolic and diastolic blood pressure levels were all decreased significantly(P<0.05). Total effective rate in treatment group was higher than that of control group (P <0.05). Conclusion:Combined with OSAHS in patients with hypertension than refractory , poor simple antihypertensive drug treatment effect,and application of positive pressure ventilation treatment, worthy of clinical application. continuous positive airway pressure (CPAP) combining with antihypertensive drug treatment is prior to simple drug treatment in the treatment of patients with obstructive sleep apnea hypopnea syndrome(OSAHS) complicated with hypertension.