【摘要】 目的 探讨长期使用持续气道正压通气（continuouspositiveairwaypressure,CPAP）对中重度阻塞性睡眠呼吸暂停（obstructivesleepapnea,OSA）合并高血压患者血压水平及血压模式（杓型或非杓型）的影响。方法 本前瞻性观察性研究纳入2017年3月至2019年12月在自治区人民医院高血压中心就诊的中重度OSA的患者，以诊室血压、动态血压及血压模式为结局指标。结果 本研究最终纳入140例受试者（男性111例，年龄49.8±9.6岁）；38例（年龄51.2±8.9岁）接受CPAP治疗，102例（年龄49.2±9.8岁）接受常规治疗。随访1年发现，CPAP组动态血压、诊室血压较基线时显著下降（P<0.05），杓型血压发生率较常规治疗组明显升高（P<0.05）。logistic回归显示，校正性别、年龄、吸烟、饮酒、基线时体重指数、胆固醇、血糖、呼吸暂停低通气指数、最低血氧饱和度，CPAP治疗与舒张压下降≥3mmHg独立相关（OR=2.42,95%CI:1.06-5.51;P=0.035），但对收缩压下降及杓型血压模式无显著影响（均P>0.05）。结论 CPAP联合降压药物治疗可改善OSA并高血压患者诊室及动态血压水平，提高杓型血压发生率。更多还原

【Abstract】 Objective To explore the impact of continuous positive airway pressure(CPAP) on changes in blood pressure level and pattern in patients with moderate-to-severe obstructive sleep apnea(OSA) with comorbid hypertension.Methods This prospective observational study enrolled patients with moderate-to-severe OSA and hypertension at Xinjiang Uyghur Autonomous Region People,s Hospital between March 2017 and December 2019. The outcomes were the level of blood pressure, including office blood pressure, and ambulatory blood pressure, and blood pressure pattern(dipper or non-dipper).Results Finally, 140 participants(111 males, aged49.8±9.6 years) were enrolled, with 38 of them(aged 51.2±8.9 years) receiving CPAP therapy, and 102(aged 49.2±9.8 years) receiving conventional therapy. At 1 year follow up, the level of ambulatory blood pressure and office blood pressure in the CPAP group were significantly decreased, and there was an increase in the occurrence of the dipper pattern compared with baseline in the CPAP group(all P<0.05). Furthermore, multivariate logistic regression analysis showed that, after adjusting for gender, age, smoking, drinking, body mass index at enrollment, cholesterol at enrollment, fasting blood glucose at enrollment, AHI, lowest oxygen saturation, CPAP therapy(RR=2.42, 95%CI: 1.06-5.51, P=0.035) was independently associated with diastolic blood pressure decreased 3 mmHg, while have no impact on systolic blood pressure decrease and dipper type of blood pressure pattern(all P>0.05).Conclusion In patients with OSA and comorbid hypertension, CPAP combined with antihypertensive drugs can improve the office and ambulatory blood pressure levels and the prevalence of the dipper pattern.更多还原