CAJ | 학술논문

目的：比较短期持续正压通气（CPAP）治疗对老年与非老年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并高血压患者的降压疗效。方法入选2012年11月至2013年5月在新疆维吾尔自治区人民医院高血压科住院经多导睡眠监测确诊的OSAHS合并高血压患者100例，按年龄分为老年组与非老年组。在原有降压药物治疗基础上，给予连续每日夜间CPAP治疗＞6h，持续1周。监测两组每日血压水平，对治疗前后血压、血压下降幅度及血压达标率做组内自身前后对照比较，分析短期CPAP治疗对两组患者降压疗效差异。结果（1）非老年组CPAP治疗第7天晨起收缩压[mSBP，（135.0±13.2） vs （140.6±15.0）mmHg，P＜0.05，1mmHg＝0.133kPa]、晨起舒张压[mDBP，（86.3±9.3） vs （93.3±11.5）mmHg，P＜0.05]、晨起平均动脉压[（102.6±9.8） vs （109.1±11.7）mmHg （P＜0.05）]均低于治疗前，第7天晨起平均动脉压下降幅度[（9.2±11.7） vs （5.0±10.7）mmHg，P＜0.05]大于第1天；老年组差异均无统计学意义（P＞0.05）；（2）非老年组CPAP治疗第7天mSBP达标率（80.7%vs 45.5%， P＜0.05）、mDBP达标率（80.7%vs 29.5%，P＜0.05）高于治疗前；老年组差异均无统计学意义（P＞0.05）。结论短期CPAP治疗对非老年OSAHS合并高血压患者降压疗效优于老年患者。
목적：비교단기지속정압통기（CPAP）치료대노년여비노년조새성수면호흡잠정저통기종합정（OSAHS）합병고혈압환자적강압료효。방법입선2012년11월지2013년5월재신강유오이자치구인민의원고혈압과주원경다도수면감측학진적OSAHS합병고혈압환자100례，안년령분위노년조여비노년조。재원유강압약물치료기출상，급여련속매일야간CPAP치료＞6h，지속1주。감측량조매일혈압수평，대치료전후혈압、혈압하강폭도급혈압체표솔주조내자신전후대조비교，분석단기CPAP치료대량조환자강압료효차이。결과（1）비노년조CPAP치료제7천신기수축압[mSBP，（135.0±13.2） vs （140.6±15.0）mmHg，P＜0.05，1mmHg＝0.133kPa]、신기서장압[mDBP，（86.3±9.3） vs （93.3±11.5）mmHg，P＜0.05]、신기평균동맥압[（102.6±9.8） vs （109.1±11.7）mmHg （P＜0.05）]균저우치료전，제7천신기평균동맥압하강폭도[（9.2±11.7） vs （5.0±10.7）mmHg，P＜0.05]대우제1천；노년조차이균무통계학의의（P＞0.05）；（2）비노년조CPAP치료제7천mSBP체표솔（80.7%vs 45.5%， P＜0.05）、mDBP체표솔（80.7%vs 29.5%，P＜0.05）고우치료전；노년조차이균무통계학의의（P＞0.05）。결론단기CPAP치료대비노년OSAHS합병고혈압환자강압료효우우노년환자。
Objective To determine the effects of short-term continuous positive airway pressure (CPAP) therapy on obstructive sleep apnea hypopnea syndrome (OSAHS) in the senile and non-senile patients with coexisting hypertension. Methods A total of 100 inpatients suffering from OSAHS determined by polysomnography and hypertension admitted in our center from November 2012 to May 2013 were subjected in this study. They were divided into 2 groups according to their age over or under 60 years old, senile (n=12) and non-senile groups (n=88). Besides pre-existing antihypertensive medication, they were all given nocturnal CPAP therapy for 7 consecutive days (>6h/night). Their daily blood pressure, pre- and post-treatment blood pressure, decrease of the pressure and ratio of those achieving target blood pressure goal were measured and calculated, and the results were compared before and after treatment, and between the 2 groups for the efficiency of CPAP therapy. Results (1) In the 7th day after treatment, the morning systolic blood pressure [mSBP, (135.0±13.2) vs (140.6±15.0)mmHg, P<0.05, 1mmHg=0.133kPa], morning diastolic blood pressure [mDBP, (86.3±9.3) vs (93.3±11.5)mmHg, P<0.05], and morning mean blood pressure [(102.6±9.8) vs (109.1±11.7)mmHg, P<0.05] were significantly reduced when compared with the values before treatment in non-senile group, and the decrease of morning mean blood pressure at day 7 was greater than at day 1 after CPAP treatment [(9.2±11.7) vs (5.0±10.7)mmHg, P<0.05]. Whereas, no such difference was seen in the senile group (P>0.05). (2) The ratios of achieving target mSBP (80.7% vs 45.5%, P<0.05) and mDBP (80.7% vs 29.5%, P<0.05) were obviously higher in the non-senile group at day 7 than before the treatment. But there was no significant difference in the senile group (P>0.05). Conclusion Short-term CPAP therapy has better efficiency in non-senile than senile patients in the treatment of OSAHS with coexisting hypertension.