CAJ | 학술논문

目的探讨持续气道正压通气（CPAP）联合降压药物对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并高血压患者血压治疗的影响，评价其降压效果。方法选择2011年8月～2014年2月在喀什地区第一人民医院确诊的108例（其中维族72例，汉族34例，柯族2例；男女比例74∶34）OSAHS合并高血压患者作为研究对象，随机将其分为对照组和CPAP治疗组，对照组52例患者，以常规降压药物治疗；CPAP治疗组有56例患者，在常规降压药物治疗基础上每晚加用CPAP治疗。持续治疗16周后，对比观察两组患者药物治疗的改变情况及24h血压监测等指标的变化情况。结果16周治疗后，CPAP组与对照组各项血压指标与治疗前均有显著差异（P＜0.05），且CPAP组各项血压指标降低幅度均高于对照组。CPAP组血压降至正常率为67.86％（38/56），对照组（＜140/90mm Hg）为50.00％（26/52）。CPAP组12例（21.44％）单药可维持血压于正常范围，5例（8.92％）需3种药物控制血压。对照组均需要2种或以上降压药控制血压，20例（38.46％）需3种药物控制血压。上述指标两组间均有显著差异（P＜0.01）。结论CPAP联合药物治疗对OSAHS合并高血压患者疗效好于单纯药物治疗。对合并高血压的OSAHS患者，CPAP治疗可以减少服用降压药的品种。
목적탐토지속기도정압통기（CPAP）연합강압약물대조새성수면호흡잠정저통기종합정（OSAHS）합병고혈압환자혈압치료적영향，평개기강압효과。방법선택2011년8월～2014년2월재객십지구제일인민의원학진적108례（기중유족72례，한족34례，가족2례；남녀비례74∶34）OSAHS합병고혈압환자작위연구대상，수궤장기분위대조조화CPAP치료조，대조조52례환자，이상규강압약물치료；CPAP치료조유56례환자，재상규강압약물치료기출상매만가용CPAP치료。지속치료16주후，대비관찰량조환자약물치료적개변정황급24h혈압감측등지표적변화정황。결과16주치료후，CPAP조여대조조각항혈압지표여치료전균유현저차이（P＜0.05），차CPAP조각항혈압지표강저폭도균고우대조조。CPAP조혈압강지정상솔위67.86％（38/56），대조조（＜140/90mm Hg）위50.00％（26/52）。CPAP조12례（21.44％）단약가유지혈압우정상범위，5례（8.92％）수3충약물공제혈압。대조조균수요2충혹이상강압약공제혈압，20례（38.46％）수3충약물공제혈압。상술지표량조간균유현저차이（P＜0.01）。결론CPAP연합약물치료대OSAHS합병고혈압환자료효호우단순약물치료。대합병고혈압적OSAHS환자，CPAP치료가이감소복용강압약적품충。
Objective To explore and analyze the efficacy of Continuous positive airway pressure(CPAP) with antihypertensive drugs in the treatment of Obstructive Sleep Apnea Hypopnea Syndrome(OSAHS) with hypertension. Methods 108 cases diagnosed OSAHS with hypertension in Kashgar region’s first people’s hospital from August 2011 to February 2014 were selected(there were 72 uighurs, 34 cases of han nationality, 2 cases of ke; Male: female was 74:34 ). They were randomly divided into the control group and CPAP treatment group, the control group had 52cases, they were given conventional antihypertensive drug; the CPAP treatment group had 56 cases, they were given CPAP treatment IM based on the conventional antihypertensive drug. After the continuous treatment for 16 week, compared and observed the changes and index changes of 24h blood pressure monitoring of drug treatment in the two groups. Results After 16 weeks treatment, compared with before the treatment, all blood pressure index of the control group and the CPAP treatment group both had significant differences(P<0.05), and decrease extent of the blood pressure index in the CPAP group were higher than the control group. The rate of Blood pressure to normal was 67.86 % (38/56) in the CPAP treatment group, the control group (<140/90mm Hg) was 50.00%(26/52). 12 cases(21.44%) in the CPAP group could maintain blood pressure in the normal range by single drug, 5 cases(8.92%) needed 3 kinds of drugs to control blood pressure. The control group needed two or more antihypertensive drugs to control blood pressure. The above indexes between the two groups all had significant differences(P < 0.01). Conclusion CPAP combined with drug treatment for OSAHS complicated with hypertension curative effect is better than the simple drug treatment. CPAP treatment can reduce the use of antihypertensive drugs varieties for hypertension patients with OSAHS.