摘要
目的探讨阻塞性睡眠呼吸暂停综合征（OSAHS）患者日间嗜睡与血压的关系。方法对2015年1月至2016年1月期间因打鼾在四川大学华西医院睡眠中心就诊的1958例患者的临床资料进行回顾性分析。患者均行整夜多导睡眠图（PSG）监测并采集Epworth嗜睡量表（ESS）评分。根据PSG结果将患者分为非OSAHS组[呼吸暂停低通气指数（AHI）〈5次／h]和OSAHS组（AHI≥5次／h），后者又根据ESS评分分为无日间嗜睡组（ESS〈14分）及日间嗜睡组（ESS≥14分）。分析比较各组患者的血压水平。通过二元逻辑回归评估有无日间嗜睡OSAHS患者罹患高血压的风险。结果纳人的1958例患者中男1580例，女378例；年龄（44．3±11．6）岁；BMI（26．4±3．8）kg／m^2。其中非OSAHS组267例、OSAHS组1691例（包括无日间嗜睡组1275例和日间嗜睡组416例）。OSAHS组高血压患病率及平均收缩压、平均舒张压、平均动脉压均显著高于非OSAHS组[53．9％比28．8％及（126．3±0．4）比（116．3±4．9）、（82．4±0．3）比（78．1±3．7）、（97．0±0．3）比（90．9±3．9）mmHg]；日间嗜睡组的平均舒张压、平均动脉压均显著高于无日间嗜睡组[（84．5±0．6）比（81．7±0．3）、（98．8±0．6）比（96．5±0．3）mmHg]（均P〈0．05）。在排除包括年龄、性别、体质指数、吸烟、饮酒、缺氧严重程度及相关睡眠指标的影响后，日间嗜睡组罹患高血压风险显著增高23％（OR=1．23，95％CI：1．01～1．65）。结论日间嗜睡是OSAHS患者罹患高血压的独立风险因素。
Objective To assess the association between daytime sleepiness and hypertension among patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods A total of 1 958 patients from Sleep Medicine Center of West China Hospital between January 2015 and January 2016 were included in the study. All subjects underwent one night polysomnography （PSG） and Epworth sleep scale （ESS） was estimated. The patients were divided into non-OSAHS group[apnea-hypopnea index （AHI） 〈5/hi and OSAHS group （AHI≥5/h） based on PSG, and then OSAHS group was further divided into those with and without daytime sleepiness groups according to ESS score （the cut point of ESS was 14）. The association between blood pressure and risk of suffering from hypertension among patients with different degree of daytime sleepiness was explored by binary logistic regression. Results There were 1 580 men and 378 women among the included patients, the mean age was （44. 3 ± 11.6 ） years old and the mean body mass index （BMI） was （26.4 ± 3.8） kg/m^2. Among these patients, there were 267 non-OSAHS and 1 691 OSAHS patients （1 275 without daytime sleepiness and 416 with daytime sleepiness）. The prevalence of hypertension was higher among OSAHS patients （53.9% vs 28.8% ） than non-OSAHS group, and OSAHS patients had higher systolic blood pressure （SBP）[ （126. 3 ± 0. 4） vs （116. 3 ±4. 9） mmHg], diastolic blood pressure （DBP） [ （82. 4± 0. 3） vs （78. 1 ± 3.7 ） mmHg ] and mean arterial pressure （MAP） [ （97.0 ±0. 3 ） vs （90. 9± 3.9） mmHg] than non-OSAHS group. And OSAHS with daytime sleepiness also had elevated DBP[ （84. 5 ±0. 6） vs （81.7 ±0. 3） mmng] and MAP[ （98.8 ±0. 6） vs （96. 5 ±0. 3） mmHg] than those without sleepiness （ all P 〈 0.05 ）. After controlling for age, sex, BMI, smoking, drinking, AH1 and related sleep parameters, OSAHS combined with daytime sleepiness increased the odds of hypertension by 23% （ OR = 1.23, 95% CI： 1.01 - 1.65 ） compared to OSAHS without daytime sleepiness. Conclusion The daytime sleepiness is an independent risk factor of hypertension in OSAHS patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第42期3370-3374,共5页
National Medical Journal of China
基金
国家自然科学基金（81530002）
国家重点基础研究发展计划（2015cB856406）
关键词
睡眠呼吸暂停
阻塞性
嗜睡
高血压
危险因素
Sleep apnea, obstructive
Daytime sleepiness
Hypertension
Risk factors
