中国现代医药杂志
中國現代醫藥雜誌
중국현대의약잡지
MODERN MEDICINE JOURNAL OF CHINA
2015年
8期
12-14
,共3页
阻塞型睡眠呼吸暂停低通气综合征%高血压%同型半胱氨酸
阻塞型睡眠呼吸暫停低通氣綜閤徵%高血壓%同型半胱氨痠
조새형수면호흡잠정저통기종합정%고혈압%동형반광안산
Obstructive sleep apnea hypopnea syndrome%Hypertension%Homocysteine
目的：通过观察阻塞型睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）及OSAHS合并高血压对血浆同型半胱氨酸（homocysteine，HCY）水平的影响，探讨血浆HCY水平与OSAHS严重程度及血压的相关性。方法选择115例无其他基础疾病的住院或门诊患者，将所有研究对象根据有无OSAHS及高血压分成3组：单纯鼾症（血压正常）组19例，OSAHS血压正常组55例，OSAHS合并高血压组41例，经整夜多导睡眠监测（PSG）后晨起测定空腹血浆HCY水平，将检测结果与睡眠呼吸监测指标进行相关性分析。结果3组之间HCY水平比较，OSAHS合并高血压组最高，OSAHS血压正常组次之，单纯鼾症组最低，差异有统计学意义（P<0.01）。采用Spearman相关分析研究OSAHS严重程度与HCY水平的相关性：HCY水平随着AHI、LAT、SLT90%、呼吸暂停总次数增加而升高（P<0.01），随着LSaO2降低而升高，说明HCY水平与OSAHS严重性存在正相关，但尚不能说明HCY水平与MSaO2、睡眠效率相关（P>0.05）。进行多重线性回归分析显示：AHI和呼吸暂停总次数与HCY较其他变量具有更显著的线性回归关系，对HCY水平影响最大，差异有统计学意义（P<0.05）。结论血压与HCY水平存在正相关，提示高HCY血症可能是高血压的一种独立危险因素。随着OSAHS睡眠呼吸紊乱程度加重，血浆HCY浓度升高，检测HCY水平可以作为预测OSAHS严重程度的辅助指标。
目的：通過觀察阻塞型睡眠呼吸暫停低通氣綜閤徵（obstructive sleep apnea hypopnea syndrome，OSAHS）及OSAHS閤併高血壓對血漿同型半胱氨痠（homocysteine，HCY）水平的影響，探討血漿HCY水平與OSAHS嚴重程度及血壓的相關性。方法選擇115例無其他基礎疾病的住院或門診患者，將所有研究對象根據有無OSAHS及高血壓分成3組：單純鼾癥（血壓正常）組19例，OSAHS血壓正常組55例，OSAHS閤併高血壓組41例，經整夜多導睡眠鑑測（PSG）後晨起測定空腹血漿HCY水平，將檢測結果與睡眠呼吸鑑測指標進行相關性分析。結果3組之間HCY水平比較，OSAHS閤併高血壓組最高，OSAHS血壓正常組次之，單純鼾癥組最低，差異有統計學意義（P<0.01）。採用Spearman相關分析研究OSAHS嚴重程度與HCY水平的相關性：HCY水平隨著AHI、LAT、SLT90%、呼吸暫停總次數增加而升高（P<0.01），隨著LSaO2降低而升高，說明HCY水平與OSAHS嚴重性存在正相關，但尚不能說明HCY水平與MSaO2、睡眠效率相關（P>0.05）。進行多重線性迴歸分析顯示：AHI和呼吸暫停總次數與HCY較其他變量具有更顯著的線性迴歸關繫，對HCY水平影響最大，差異有統計學意義（P<0.05）。結論血壓與HCY水平存在正相關，提示高HCY血癥可能是高血壓的一種獨立危險因素。隨著OSAHS睡眠呼吸紊亂程度加重，血漿HCY濃度升高，檢測HCY水平可以作為預測OSAHS嚴重程度的輔助指標。
목적：통과관찰조새형수면호흡잠정저통기종합정（obstructive sleep apnea hypopnea syndrome，OSAHS）급OSAHS합병고혈압대혈장동형반광안산（homocysteine，HCY）수평적영향，탐토혈장HCY수평여OSAHS엄중정도급혈압적상관성。방법선택115례무기타기출질병적주원혹문진환자，장소유연구대상근거유무OSAHS급고혈압분성3조：단순한증（혈압정상）조19례，OSAHS혈압정상조55례，OSAHS합병고혈압조41례，경정야다도수면감측（PSG）후신기측정공복혈장HCY수평，장검측결과여수면호흡감측지표진행상관성분석。결과3조지간HCY수평비교，OSAHS합병고혈압조최고，OSAHS혈압정상조차지，단순한증조최저，차이유통계학의의（P<0.01）。채용Spearman상관분석연구OSAHS엄중정도여HCY수평적상관성：HCY수평수착AHI、LAT、SLT90%、호흡잠정총차수증가이승고（P<0.01），수착LSaO2강저이승고，설명HCY수평여OSAHS엄중성존재정상관，단상불능설명HCY수평여MSaO2、수면효솔상관（P>0.05）。진행다중선성회귀분석현시：AHI화호흡잠정총차수여HCY교기타변량구유경현저적선성회귀관계，대HCY수평영향최대，차이유통계학의의（P<0.05）。결론혈압여HCY수평존재정상관，제시고HCY혈증가능시고혈압적일충독립위험인소。수착OSAHS수면호흡문란정도가중，혈장HCY농도승고，검측HCY수평가이작위예측OSAHS엄중정도적보조지표。
Objective To observe the influence of obstructive sleep apnea hypopnea syndrom (OSAHS) and OSAHS combined with hypertension on plasma homocysteine (HCY) level, discuss the correlation of HCY and the severity of OSAHS and blood pressure. Methods 115 cases without other basic diseases were divided into 3 groups according to the presence of OSAHS and hypertension: 19 cases in pure sleep apnea (normal blood pressure) group, 55 cases in OSAHS and normal blood pressure group, and 41 cases in OSAHS with hypertension group. The correlation of plasma HCY levels and the results with sleep apnea monitoring index by using all night polysomnography(PSG) were analysed. Results The levels of HCY from high to low were OSAHS combined with hypertension group, OSAHS and normal blood pressure group and pure sleep apnea group. The difference was statistically significant (P<0.01). Spearman correlation analysis was carried out to study the correlation be-tween OSAHS severity and HCY levels: HCY levels increased with the increase of AHI, LAT, SLT90% and the total of apnea (P<0.01) and the decrease of LSaO2, HCY level was positively correlated with OSAHS severity, but couldn't explain the HCY associated with MSaO2 and sleep efficiency (P>0.05). Multiple linear regression analysis showed that apnea total number and AHI had more remarkably relationship than other variable with HCY level, the difference was statistically significant (P<0.05). Conclusion Blood pressure is positively correlated with HCY, the high HCY levels may be an independent risking factor of hypertension. With sleep-related breathing disorder degree of OSAHS aggravating, the plasma HCY level elevates, detection of HCY levels can predict the severity of OSAHS as auxiliary index.
