CAJ | 학술논문

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）合并高血压患者动态血压特点，尤其是早晨血压高峰出现率及出现时间，并分析其相关因素。方法选取2O11年1月-2O12年12月因打鼾在广西壮族自治区人民医院睡眠呼吸疾病诊疗中心行多导睡眠图（ PSF）检测确诊为OSAHS患者，根据有无高血压分为OSAHS高血压组和单纯OSAHS组。同时，在高血压门诊随机选取无打鼾的高血压患者为对照1组（单纯高血压组），在体检中心和我院职工中随机招募无打鼾无高血压者为对照2组（正常组）。对4组人群行24 h动态血压监测并对其数据进行分析，比较4组非杓型血压发生率、早晨血压高峰出现率和出现的时间。结果 OSAHS高血压组非杓型血压发生率为86.4%（38/44），单纯OSAHS组为79.1%（91/115），单纯高血压组为45.8%（11/24），正常组为23.3%（7/3O），4组比较差异有统计学意义（ P<O. O1）；OSAHS高血压组早晨血压高峰发生率为84.1%（37/44），单纯OSAHS组为5O.4%（58/115），单纯高血压组为37.5%（11/24），正常组为26.7%（8/22），4组比较差异有统计学意义（ P<O. O1）。早晨血压高峰出现时间：OSAHS高血压组5：OO~6：OO出现率最高，为86.4%（38/44）；单纯OSAHS组5：OO~6：OO出现率最高，为6O.9%（7O/115）；单纯高血压组7：OO~8：OO出现率最高，为37.5%（5/24）；正常组在早晨各时段出现率无差异。结论 OSAHS高血压组与单纯OSAHS组、单纯高血压组、正常组全天血压变化规律存在差异，OSAHS高血压组非杓型血压及早晨血压高峰发生率明显增加，OSAHS高血压组、单纯OSAHS组早晨血压高峰出现时间比单纯高血压组出现时间提前。
목적：탐토조새성수면호흡잠정저통기종합정（ OSAHS）합병고혈압환자동태혈압특점，우기시조신혈압고봉출현솔급출현시간，병분석기상관인소。방법선취2O11년1월-2O12년12월인타한재엄서장족자치구인민의원수면호흡질병진료중심행다도수면도（ PSF）검측학진위OSAHS환자，근거유무고혈압분위OSAHS고혈압조화단순OSAHS조。동시，재고혈압문진수궤선취무타한적고혈압환자위대조1조（단순고혈압조），재체검중심화아원직공중수궤초모무타한무고혈압자위대조2조（정상조）。대4조인군행24 h동태혈압감측병대기수거진행분석，비교4조비표형혈압발생솔、조신혈압고봉출현솔화출현적시간。결과 OSAHS고혈압조비표형혈압발생솔위86.4%（38/44），단순OSAHS조위79.1%（91/115），단순고혈압조위45.8%（11/24），정상조위23.3%（7/3O），4조비교차이유통계학의의（ P<O. O1）；OSAHS고혈압조조신혈압고봉발생솔위84.1%（37/44），단순OSAHS조위5O.4%（58/115），단순고혈압조위37.5%（11/24），정상조위26.7%（8/22），4조비교차이유통계학의의（ P<O. O1）。조신혈압고봉출현시간：OSAHS고혈압조5：OO~6：OO출현솔최고，위86.4%（38/44）；단순OSAHS조5：OO~6：OO출현솔최고，위6O.9%（7O/115）；단순고혈압조7：OO~8：OO출현솔최고，위37.5%（5/24）；정상조재조신각시단출현솔무차이。결론 OSAHS고혈압조여단순OSAHS조、단순고혈압조、정상조전천혈압변화규률존재차이，OSAHS고혈압조비표형혈압급조신혈압고봉발생솔명현증가，OSAHS고혈압조、단순OSAHS조조신혈압고봉출현시간비단순고혈압조출현시간제전。
Objective Toresearchthecharacteristicsofdynamicbloodpressureinhypertensionpatientscombined withOSAHS,especiallytheincidenceofmorningbloodpeakandappearingtime,andanalyzeitsrelatedfactors.Methods Pa-tients visiting our sleep-related disorder center because of snoring later diagnosed as OSAHS by PSF detection were divided into OSAHS hypertension group and OSAHS group. At the same time,hypertension patients without snoring randomly selected in hy-pertension clinic served as control 1 group( hypertension group)and healthy people without hypertension and snoring randomly re-cruited in physical check-up center and staff served as control 2 group( normal group ) . Detect the 24 hours dynamic blood pressure of 4 groups,then compare the incidence of dipper type blood pressure and the incidence of the morning surge and the ap-pearingtimeofthe4groups.Results Theincidenceofnondippertypebloodpressure:OSAHShypertensiongroupwas86.4%(38/44),OSAHS group was 79. 1%(91/115),and hypertension group was 45. 8%(11/24),normal group was 23. 3%(7/3O),there were significant difference among four groups( P <O. O1 ) . The incidence of morning blood pressure surge:OSAHS hypertension group was 84. 1%(37/44),OSAHS group was 5O. 4%(58/115),and hypertension group was 37. 5%(11/24),normal group was 26. 7%(8/22),there were significant difference among four groups(P <O. O1). Appearing time:OSAHS hypertension groups had the highest rate at 5-6 am and the rate was 86. 4%(38/44);OSAHS groups had it at 5-6 am and the rate was 6O. 9%(7O/115);hypertension group had it at 7-8 am and the rate was 37. 5%(5/24);Normalgroupshowednodifferenceeachtimeinthemorning.Conclusion ThechangeofbloodpressurewithinonedayinOSAHShyper-tension group,OSAHS group,hypertension group,normal group is different. In OSAHS hypertension group,the incidence of non dipper type blood pressure and morning blood pressure surge is higher significantly. Morning blood pressure surge appearing time in OSAHS hypertension group and OSAHS group is earlier than that in hypertension group.