中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
4期
490-494
,共5页
高血压%阻塞性睡眠呼吸暂停低通气综合征%持续正压通气
高血壓%阻塞性睡眠呼吸暫停低通氣綜閤徵%持續正壓通氣
고혈압%조새성수면호흡잠정저통기종합정%지속정압통기
Hypertension%Obstructive sleep apnea syndrome%Continuous positive airway pressure
目的 了解呼吸干预在高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)治疗中的作用.方法 采用回顾性研究方法,分析2012年4月至2013年5月在北京大学人民医院住院的高血压合并OSAHS患者383例的病历资料,根据是否使用持续正压通气(CPAP)治疗将上述高血压合并OSAHS患者分为2组,CPAP治疗组(144例)及未经CPAP治疗的对照组(239例).对这些患者的临床特点、性别年龄分布及呼吸干预治疗情况进行分析.结果 383例高血压合并OSAHS患者高血压的发病年龄低于普通人群,45岁以下诊断高血压病者达52.9％(203/383);所有患者中男306例,女77例,男女比例为3.97∶1.CPAP治疗组的患者治疗后收缩压、舒张压、体重指数明显下降,与对照组比较差异有统计学意义[(130.0±7.6)mmHg(1 mmHg=0.133 kPa)比(150.0±12.2) mmHg、(85.0±2.1)mmHg比(93.0±2.3) mmHg、(24.8 ±2.6) kg/m2比(26.9±2.7) kg/m2] (P＜0.05).睡眠呼吸暂停低通气指数、夜间最低血氧饱和度也较治疗前有明显改善[(3.5±1.2)比(48.5±10.6)、(89.5±5.2)％比(75.1±8.5)％](P＜0.01);部分患者降压药物减量或停用,仅用CPAP治疗就能维持正常血压.结论 睡眠呼吸暂停相关性高血压患者高血压的发病年龄趋于年轻.患者经CPAP治疗后,不但可改善睡眠呼吸障碍,还可以有效控制血压,提示对于高血压患者来说进行OSAHS的筛查十分必要,而CPAP的治疗对高血压合并OSAHS患者是一种行之有效的抗高血压治疗.
目的 瞭解呼吸榦預在高血壓閤併阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)治療中的作用.方法 採用迴顧性研究方法,分析2012年4月至2013年5月在北京大學人民醫院住院的高血壓閤併OSAHS患者383例的病歷資料,根據是否使用持續正壓通氣(CPAP)治療將上述高血壓閤併OSAHS患者分為2組,CPAP治療組(144例)及未經CPAP治療的對照組(239例).對這些患者的臨床特點、性彆年齡分佈及呼吸榦預治療情況進行分析.結果 383例高血壓閤併OSAHS患者高血壓的髮病年齡低于普通人群,45歲以下診斷高血壓病者達52.9％(203/383);所有患者中男306例,女77例,男女比例為3.97∶1.CPAP治療組的患者治療後收縮壓、舒張壓、體重指數明顯下降,與對照組比較差異有統計學意義[(130.0±7.6)mmHg(1 mmHg=0.133 kPa)比(150.0±12.2) mmHg、(85.0±2.1)mmHg比(93.0±2.3) mmHg、(24.8 ±2.6) kg/m2比(26.9±2.7) kg/m2] (P＜0.05).睡眠呼吸暫停低通氣指數、夜間最低血氧飽和度也較治療前有明顯改善[(3.5±1.2)比(48.5±10.6)、(89.5±5.2)％比(75.1±8.5)％](P＜0.01);部分患者降壓藥物減量或停用,僅用CPAP治療就能維持正常血壓.結論 睡眠呼吸暫停相關性高血壓患者高血壓的髮病年齡趨于年輕.患者經CPAP治療後,不但可改善睡眠呼吸障礙,還可以有效控製血壓,提示對于高血壓患者來說進行OSAHS的篩查十分必要,而CPAP的治療對高血壓閤併OSAHS患者是一種行之有效的抗高血壓治療.
목적 료해호흡간예재고혈압합병조새성수면호흡잠정저통기종합정(OSAHS)치료중적작용.방법 채용회고성연구방법,분석2012년4월지2013년5월재북경대학인민의원주원적고혈압합병OSAHS환자383례적병력자료,근거시부사용지속정압통기(CPAP)치료장상술고혈압합병OSAHS환자분위2조,CPAP치료조(144례)급미경CPAP치료적대조조(239례).대저사환자적림상특점、성별년령분포급호흡간예치료정황진행분석.결과 383례고혈압합병OSAHS환자고혈압적발병년령저우보통인군,45세이하진단고혈압병자체52.9％(203/383);소유환자중남306례,녀77례,남녀비례위3.97∶1.CPAP치료조적환자치료후수축압、서장압、체중지수명현하강,여대조조비교차이유통계학의의[(130.0±7.6)mmHg(1 mmHg=0.133 kPa)비(150.0±12.2) mmHg、(85.0±2.1)mmHg비(93.0±2.3) mmHg、(24.8 ±2.6) kg/m2비(26.9±2.7) kg/m2] (P＜0.05).수면호흡잠정저통기지수、야간최저혈양포화도야교치료전유명현개선[(3.5±1.2)비(48.5±10.6)、(89.5±5.2)％비(75.1±8.5)％](P＜0.01);부분환자강압약물감량혹정용,부용CPAP치료취능유지정상혈압.결론 수면호흡잠정상관성고혈압환자고혈압적발병년령추우년경.환자경CPAP치료후,불단가개선수면호흡장애,환가이유효공제혈압,제시대우고혈압환자래설진행OSAHS적사사십분필요,이CPAP적치료대고혈압합병OSAHS환자시일충행지유효적항고혈압치료.
Objective To analyze clinical characteristics,sex and age distributions,and treatment of hypertensive patients related obstructive sleep apnea syndrome (OSAHS),to understand the importance of respiratory intervention eombined with OSAHS in the treatment of hypertension.Methods Retrospective study was used to analyze 587 inpatients who were diagnosed with sleep apnea syndrome combined,among these patients,383 with hypertension in our hospital from April 2012 to May 2013.And 144 patients received at least 3 months continuous positive airway pressure (CPAP) therapy.The study aims to analyze the clinical characteristics,sex and age distributions,and respiratory intervention respiratory intervention treatment status of these patients.Results Among the 383 sleep apnea syndrome related hypertensive patients,patients developed hypertension younger than the general population and the patients younger than 45 years old with diagnosis of hypertension accounted for 52.9％.There were 306 males and 77 females among all patients with the ratio of 3.91 to 1.After CPAP treatment,the systolic blood pressures,diastolic blood pressures,BMI were significantly decreased [(130.0 ± 7.6) mmHg vs (150.0 ± 12.2)mmHg,(85.0±2.l)mmHg vs (93.0 ±2.3)mmHg,(24.8 ±2.6)kg/m2 vs (26.9±2.7) kg/m2] (P＜ 0.05).Sleep apnea hypopnea index and night minimum oxygen saturation were significantly improved [(3.5 ± 1.2) vs (48.5±10.6),(89.5 ±5.2)％ vs (75.1 ±8.5)％] (P＜0.01).Some of the patients reduced or stopped antihypertensive medications and only used CPAP to keep the normal blood pressure.Conclusions Sleep apnea syndrome related hypertensive patients the age of onset developed hypertension with young tendency.After CPAP treatment,the sleep respiratory disorder is greatly improved and blood pressure is well controlled,indicating that the screening for OSAHS is essential for hypertensive patients.CPAP treatment is an effective antihypertensive treatment for the hypertension combined with OSAHS patients.
