CPAP治疗对阻塞型睡眠呼吸暂停患者血压变异性的影响

摘要

Objective; To investigate the effect of continuous positive airway pressure (CPAP) treatment on blood pressure variability in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods:102 patients underwent baseline diagnostic polysomnography (PSG) and 24-hour ambulatory blood pressure (ABP), and then were divided into normal, mild and moderate to severe OSAHS. We analyzed the differences of the 24-h BP in each group. 39 patients with moderate to severe OSAHS received 8-week CPAP treatment. Then we assessed the effect of CPAP treatment on blood pressure variability. Results: Patients with moderate to severe OSAHS had significantly higher 24-h mean BP than other group (P<0. 01 ); patients who received CPAP treatment showed decreases in the blood pressure variability ( P < 0. 05). Conclusion: Patients with moderate to severe OSA have significant change in 24-h BP, and effective CPAP treatment in these patients leads to reduction in blood pressure variability.%目的:探讨经鼻持续正压通气(nCPAP)治疗对阻塞性睡眠呼吸暂停综合征(OSAHS)患者血压变异性的影响. 方法:采用24 h动态血压监测与多导睡眠(PSG)同步监测的方法,对102例OSAHS受试者按睡眠呼吸暂停紊乱指数(AHI)分为正常对照组、轻度组和中重度组,观察3组患者的血压情况；对中重度组加用nCPAP治疗后,再观察各项指标的改变. 结果:中重度组患者的平均血压水平均高于对照组及轻度组(P＜0.01)；中重度组患者经nCPAP治疗8周后,血压变异性包括晨峰现象、非杓型血压比例均较治疗前有明显下降(P＜0.05). 结论:OSAHS患者的血压有特征性变化,中重度患者接受有效的nCPAP治疗后,不仅纠正了呼吸障碍,也改善了血压变异性及晨峰现象.