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目的探讨降压药对与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者相关的血压及动脉硬度的作用。方法61例经多导睡眠图证实的OSAHS患者被纳入本研究,女13例,男48例,平均年龄(53±12)岁,其中血压正常者(N组)26例,未服用降压药的高血压患者(H组)7例,接受联合降压药治疗的高血压患者(HM组)28例。通过对经无创压力传感装置记录的数字化桡动脉每搏波形进行分析,计算增加的收缩压与脉压的比值而得出动脉增加指数(AAI)。以其作为测量动脉硬度的一个指标分别对清醒期、阻塞早期、阻塞晚期及后阻塞期的数据进行分析以获得各期平均血压及AAI。结果3组患者后阻塞期的收缩压比清醒期、阻塞早期及阻塞晚期均有显著升高(P<0.01)。N组的AAI从清醒期[(10.5±2.6)%]到阻塞晚期[(14.4±3.2)%]及从阻塞早期[(10.6±2.3)%]至阻塞晚期[(14.4±3.2)%]都有显著升高(P<0.01);H组的AAI从清醒期[(11.2±3.9)%]至阻塞晚期[(16.3±8.0)%]及从阻塞早期[(11.8±3.8)%]至阻塞晚期[(16.3±8.0)%]也有显著升高(P<0.05);但HM组各期之间的AAI差异无统计学意义。结论OSAHS患者在发生阻塞性事件时,其系统血压在阻塞后微觉醒期有显著升高,且不能被联合降压药降低;动脉硬度在阻塞晚期显著增加但可被联合降压药物减轻。
Objective To investigate the effect of antihypertensive drugs on blood pressure and arterial stiffness in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Sixty-one OSAHS patients confirmed by polysomnography were enrolled in this study. There were 13 females and 48 females with a mean age of (53 ± 12) years, including 26 with normotensives (N group) and no antihypertensive drugs Of hypertensive patients (H group), 7 patients received hypertension combined with antihypertensive drugs (HM group) 28 cases. The arterial augmentation index (AAI) was calculated by calculating the ratio of increased systolic pressure to pulse pressure by analyzing the digitized radial artery pulse wave recorded by a non-invasive pressure sensing device. Using it as an index to measure arterial stiffness, the data of early awake, early occlusion and late occlusion of obstruction were analyzed respectively to obtain mean blood pressure and AAI of each stage. Results The systolic pressure of obstructive phase in the three groups was significantly higher than that in awake, early occlusion and late occlusion (P <0.01). The AAI of group N from awake ([10.5 ± 2.6]%] to late stage of obstruction (14.4 ± 3.2)% and from early stage of obstruction (10.6 ± 2.3)% to late stage of obstruction (14.4 ± 3.2)% (11.2 ± 3.9)%] to late stage of obstruction [(16.3 ± 8.0)%], and from the early stage of obstruction (11.8 ± 3.8%) to obstruction The late [(16.3 ± 8.0)%] were also significantly increased (P <0.05), but there was no significant difference in the AAI between HM groups. Conclusion OSAHS patients with obstructive events, the system of blood pressure in the post-obstruction arousal increased significantly, and can not be combined with antihypertensive drugs decreased; arterial stiffness in the late obstruction significantly increased but can be combined antihypertensive drugs to reduce.