摘要
目的探讨阻塞性夜间呼吸暂停综合征(OSAHS)相关高血压与脉搏波传播速度的关系。方法选择于2014年6月—2018年6月期间在阳江市人民医院门诊和住院已确诊为原发性高血压患者中选取70例作为对照组,在医院行多导睡眠图监测(polysomnography,PSG)确诊的OSAHS患者中随机抽取500例行动态血压检查,从合并高血压患者中再随机选取70例作为观察组,两组患者均未降压治疗且排除糖尿病患者。对两组患者进行数据分析,臂踝脉搏波传导速度(baPWV)、尿微量白蛋白(MAU)、24 h动态血压监测(ABPM)、室间隔厚度(PWT)、左心室后壁厚度IVST、体质指数BMI、颈动脉内中膜厚度IMT等。结果观察组baPWV平均值为(26±3.2),BMI平均值为(26±3.8),对照组为baPWV平均值为(18±4.8),BMI平均值为(22±2.3),差异有统计学意义(P<0.05)。观察组的昼夜血压节律出现反杓型、清晨高血压、血压昼夜节律紊乱消失的比例比对照组高,差异有统计学意义(P<0.001)。结论观察组比对照组臂踝脉搏波传导速度明显增快,其他指标也有不同程度的差异,说明OSAHS相关高血压患者比单纯高血压患者的血管弹性更差,血管更僵硬。OSAHS本身是引起动脉粥样硬化的一个独立指标,因此,对OSAH相关高血压患者,除了针对高血压治疗,更重要的是针对OSAHS的治疗。
Objective To investigate the relationship between hypertension associated with obstructive sleep apnea syndrome(OSAHS)and pulse wave propagation velocity.Methods 70 outpatients and inpatients in the hospital who were diagnosed with essential hypertension from June,2014 to June,2018 were selected as control group,500 ambulatory blood pressure tests were randomly selected from patients with obstructive nocturnal apnea syndrome diagnosed by polysomnography in the hospital,and 70 patients with hypertension were randomly selected as observation group.Two groups did not receive antihypertensive treatment and excluded diabetic patients.The following data were analyzed,including brachial-ankle pulse wave conduction velocity(baPWV),microalbuminuria(MAU),24-hour ambulatory blood pressure monitoring(ABPM0),interventricular septal thickness(PWT),left ventricular posterior wall thickness(IVST),body mass index(BMI)and carotid intima-media thickness(IMT),etc.Results The mean value of baPWV in the observation group was(26±3.2),the mean value of BMI was(26±3.8),the mean value of baPWV in the control group was(18±4.8),and the mean value of BMI was(22±2.3).The difference was statistically significant(P<0.05).The rate of diurnal blood pressure rhythm in observation group was higher than that in control group(P<0.001).Conclusion The velocity of brachial and ankle pulse wave conduction was significantly increased in the observation group compared with the control group,and there were also differences in other indicators to different degrees,indicating that the vascular elasticity of patients with osahs-related hypertension was worse and the blood vessels were more rigid than those with simple hypertension.Conclusion OSAHS itself is an independent indicator of atherosclerosis.Therefore,for patients with osah-associated hypertension,in addition to the treatment of hypertension itself,OSAHS treatment is more important.
作者
阮敏
郑伊颖
杨方权
RAUN Min;ZHENG Yi-ying;YANG Fang-quan(Cardiovascular Medicine Department,Jiangyang People’s Hospital,Jiangyang,Guangdong,529500,China)
出处
《黑龙江医学》
2020年第11期1527-1529,共3页
Heilongjiang Medical Journal
