【摘要】 目的探讨高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床特点及合并心血管危险因素情况。方法采用回顾性研究方法,分析高血压专科诊断明确的高血压患者1666例,根据多导睡眠仪监测结果分为单纯高血压组(Ⅰ组,n=359),高血压合并轻度OSAHS组(Ⅱ组,n=503),高血压合并中度OSAHS组(Ⅲ组,n=376),高血压合并重度OSAHS组(Ⅳ组,n=428)。对4组患者的临床特点和合并心血管危险因素等进行相关分析。结果Ⅰ组的年龄、体质量指数(BMI)、睡眠呼吸暂停低通气指数(AHI)及总胆固醇均低于Ⅱ组、Ⅲ组和Ⅳ组,差异有统计学意义(P<0.01);Ⅲ组的年龄、AHI和低密度脂蛋白胆固醇(LDL-C)均高于Ⅱ组(P<0.01);随着OSAHS病情程度的增加,吸烟、高血脂症、高血糖、高敏C反应蛋白(hsCRP)升高和肥胖的检出率均有所升高(P<0.01),伴随危险因素个数的检出率明显增高(χ2=117.360,P<0.01);多元线性回归分析发现年龄、性别、BMI、空腹血糖和早发心血管病家族史是影响OSAHS发生的相关危险因素。结论高血压合并OSAHS常伴发有肥胖和糖脂代谢紊乱等心血管危险因素,尤其高血压合并重度OSAHS患者是心血管危险因素聚集发生的常见人群,性别和BMI与OSAHS的发生关系密切。更多还原

【Abstract】 Objective To study the clinical characteristics and cardiovascular risk factors in hypertensive patients with obstructive sleep apnea hypopnea syndrome.Methods Retrospective study was performed in hypertensive patients at department of hypertension.One thousand six hundred sixty six hypertensive patients were enrolled,which were classified into four groups according to the finding of polysomnography(PSG):hypertension without obstructive sleep apnea-hypopnea syndrome(OSAHS)(group Ⅰ,n=359),hypertension with mild OSAHS(group Ⅱ,n=503),hypertension with moderate OSAHS(group Ⅲ,n=376)and hypertension with severe OSAHS(group Ⅳ,n=428).The clinical characteristics and cardiovascular risk factors of patients were compared among the four groups.Results Compared without group Ⅰ,patients in the other groups had higher mean values of age,body mass index(BMI),apnea-hypopnea index(AHI)and total cholesterol(TC)(P<0.01).Age,AHI and low density lipoprotein-cholesterol(LDL-C)in mild OSAHS group showed a lower level than that in moderate OSAHS group(P<0.01).The detection rate of smoking,dyslipidemia,hyperglycemia,high sensitivity C reactive protein(hs-CRP)and obesity significantly increased with the severity of OSAHS(P<0.05).Multiple linear regression analysis showed that age,gender,BMI,fasting plasma glucose and family history of early onset of cardiovascular disease were the risk factors of OSAHS.Conclusion Hypertension with OSAHS is frequently accompanied with metabolic disturbance of carbohydrate and lipid,especially for hypertensive patients with severe OSAHS.Gender and BMI are closely related to OSAHS.更多还原