nCPAP治疗对OSAHS合并EMBPS高血压患者血压的影响

摘要

Objective To investigate the effect of nasal continuous positive airway pressure ( nCPAP ) on hypertensives complicated with moderate or severe obstructive sleep apnea - hypopnea syndrome ( OSAHS ) and early morning blood pressure surge ( EMBPS ). Methods Based on the result of polysomnography ( PSG ) and 24 hour ambulatory hlood pressure monitoring ( ABPM ),34 hypertensives complicated with moderate or severe OSAHS and EMBPS were involved. They were divided into treatment group of 20 cases and control group of 14 cases. The average systolic pressure ( AvSP ). average diastolic pressure ( AvDP ), mean arterial hlood pressure ( MABP ) of the EMBPS were calculated. The treatment group received 5 days of nCPAP treatment. Both groups were examined the ahove indexs on the fifth day. The difference between the treatment group and the control group was analyzed. Results The AvSP ( 30. 03 ±7. 77 mmHg ) and MABP ( 24 . 61 ± 8. 19 mmHg ) of the EMBPS declined remarkahly verse pretherapy ( 35.96 ±5. 18 , 29. 18 ±6. 76mmHg ) in the treatment group ( P ＜ 0. 05 ). Conclusion These data suggest that OSAHS may contribute to EMBPS. It emphasizes the importance of using nCPAP on hypertensives complicated with moderate or severe OSAHS.Patients whose blood pressure can not he controlled by medicine should receive PSG examination to screen OSAHS.%目的 观察经鼻持续气道正压通气(nCPAP)治疗对中重度阻塞型睡眠呼吸暂停低通气综合征(OSAHS)合并血压晨峰(EMBPS)的高血压患者EMBPS水平的影响.方法 通过多导睡眠图(PSG)和24 h动态血压监测(ABPM)入选中重度OSAHS合并EMBPS的高血压患者34例,其中治疗组20例,对照组14例.计算血压晨峰的平均收缩压( AvSP)、平均舒张压(AvDP)、平均动脉压(MABP).治疗组连续5晚使用nCPAP治疗.所有研究对象均于实验第5日再次行ABPM检测以上指标.比较两组在观察前后血压的差别.结果 治疗组治疗后血压晨峰AvSP(30.03±7.77 mmHg)、血压晨峰MABP(24.61±8.19 mmHg)较治疗前(35.96±5.18、29.18±6.76 mmHg)下降,差异有统计学意义(P＜0.05).结论 OSAHS可能是高血压EMBPS的促成因素之一.对合并高血压的中重度OSAHS患者进行nCPAP治疗具有重要意义.对于药物控制不理想的此类临床患者,可进行PSG检查,筛查OSAHS,并对中重度患者进行nCPAP治疗.