阻塞性睡眠呼吸暂停综合征合并高血压与红细胞分布宽度的关系

摘要

目的：探讨阻塞性睡眠呼吸暂停综合征（OSAS）合并高血压与红细胞分布宽度（RDW）的关系。方法选择2011年1月至2013年8月在中国人民解放军第九四医院呼吸内科门诊及住院的 OSAS 合并高血压患者（OSAS合并高血压组）44例和体检中心体检的原发性高血压患者（高血压组）57例、健康体检者（正常对照组）52例。各组清晨空腹抽取肘静脉血2 mL，用全自动五分类血细胞分析仪检测红细胞（RBC）计数、血红蛋白（Hb）、RDW 及白细胞（WBC）计数，比较各组 RDW 的差异，并进行相关性分析。结果高血压组 RBC 计数、Hb、RDW 和 WBC 计数与正常对照组比较差异均无统计学意义（均 P ＞0．05）；OSAS 合并高血压组 BMI、DBP、RBC 计数、Hb 和 RDW 均明显高于正常对照组、高血压组，SBP 明显高于正常对照组、明显低于高血压组（均 P ＜0．05）；高血压组 SBP、DBP均明显高于正常对照组（均 P ＜0．05）。相关性分析结果显示，OSAS 合并高血压组 RDW 与睡眠呼吸暂停低通气指数（AHI）呈正相关（r＝0．426，P ＜0．05），与最低氧饱和度呈负相关（r＝－0．509，P ＜0．05）。结论高血压患者RDW 无明显改变，RDW 增高可能是 OSAS 合并高血压患者心脑血管事件的标志物。%Objective To explore the relationship between obstructive sleep apnea syndrome (OSAS)accompanied by hypertension and red blood cell distribution width(RDW).Methods Forty-four patients with OSAS accompanied by hypertension who were treated in the department of respiratory medicine in the 94th Hospital of the Chinese People’s Liberation Army from January 2011 to August 2013(OSAS accompanied by hypertension group)and 57 patients with primary hypertension(hypertension group)and 52 healthy physical examinees(normal control group)who were examined at physical examination center during the same period were selected in this study. Fasting venous blood samples(2 mL)were drawn and red blood cell(RBC)count,hemoglobin (Hb),RDW and white blood cell (WBC)count were detected by automatic five classification blood cell analyzer.The differences in RDW were compared among the three groups and the corre-lation analysis was performed.Results There were no significant differences in RBC count,Hb, RDW and WBC count between hypertension group and normal control group(P > 0.05).Com-pared with OSAS accompanied by hypertension group,body mass index(BMI),diastolic blood pressure(DBP),RBC count,Hb and RDW were reduced in both normal control group and hyper-tension group,and systolic blood pressure(SBP)was decreased in normal control group but was increased in hypertension group(P <0.05).Compared with normal control group,both SBP and DBP were increased in hypertension group(P <0.05).The correlation analysis showed that RDW was positively associated with the apnea hypopnea index(r=0.426,P <0.05)but was negatively associated with the lowest oxygen saturation(r=-0.509,P <0.05)in OSAS accompanied by hy-pertension group.Conclusion The RDW does not change obviously in patients with hyperten-sion.The increase in RDW may be a marker of cardiovascular and cerebrovascular events in pa-tients with OSAS accompanied by hypertension.