【作者】 朱宇清； 龙杞； 王辰； 帅学军； 陈博； 孔晶； 魏育林；

【Author】 ZHU Yu-qing;LONG Qi;WANG Chen;SHUAI Xue-jun;CHEN Bo;KONG Jing;WEI Yu-lin;Internation Medical Center,China-Japan Friendship Hospital;

【机构】 中日友好医院；

【摘要】 目的运用心肺耦合测评分析技术观察睡眠呼吸暂停综合征(SAS)患者睡眠结构和24h血压变化的特点。方法纳入匹兹堡睡眠质量指数(PSQI)≥8分的睡眠障碍患者共79例,均来自中日友好医院国际医疗部睡眠中心。采用基于心肺耦合技术的便携式睡眠质量监测仪和24h动态血压监测仪进行同步监测,采集相关数据。根据睡眠质量监测仪分析的呼吸暂停低通气指数(AHI)将患者分为睡眠呼吸暂停综合征组47例和非睡眠呼吸暂停综合征组32例,分析两组间睡眠结构和24h血压波动的差异,在总体样本中分析AHI与睡眠结构数据和血压数据的相关性。结果 SAS组患者睡眠结构中深睡时间和深睡时间占总睡眠时长比例低于非SAS组患者,而浅睡时间占总睡眠时长比例高于非SAS患者,差异具有统计学意义(p<0.05);AHI与深睡时间、醒/做梦时间呈中度负相关(0.3<r≤0.6),与浅睡时间呈中度正相关(0.3<r≤0.6);SAS组患者24小时及白天平均收缩压及舒张压高于非SAS组患者,夜间收缩压下降幅度低于非SAS组患者,夜间收缩压超过极限值比率、夜间平均心率高于非SAS患者,差异具有统计学意义(p<0.05);AHI与夜间舒张压下降幅度呈高度负相关(r=-0.785,p=0.000);与夜间收缩压下降幅度(r=-0.398,p=0.029)呈中度负相关,与平均舒张压水平呈中度正相关(r=0.425,p=0.019)。结论伴SAS的睡眠障碍患者睡眠异常较无SAS者严重;睡眠结构异常程度、血压水平与SAS严重程度有一定的正相关关系。更多还原

【Abstract】 Objective To investigate sleep architecture and blood pressure dynamic change in patients with Sleep apnea syndrome by electrocardiogram-based cardiopulmonary coupling analysis system.Methods 79 sleep disorder participants(PSQI≥8) were enrolled,electrocardiogram-based cardiopulmonary coupling analysis device and ambulatory blood pressure monitoring were used synchronously to evaluate sleep architecture and blood pressure circadian rhythm.The patients were divided into SAS group(47 participants) and non-SAS group(32 participants)according to the Apnea Hypopnea Index(AHI) that calculated by CPC device,the data of sleep architecture and blood pressure variability were compared between two groups.Results compared with non-SAS group,SAS group have less proportion of deep sleep,more proportion of light sleep,higher mean boold pressure in 24 hours and daytime,lower nocturnal blood pressure dipping,faster mean heart rate in night time(p<0.05).AHI has moderate inverse correlation with deep sleep time,wake/dream time(0.3<r≤0.6,moderate positive correlation with light sleep time(0.3<r≤0.6),high inverse correlation with nocturnal blood pressure dipping(r=-0.785,p=0.000),moderate positive correlation with mean diastolic blood pressure(r=0.425,p=0.019).Conclusion Our study finds less proportion of deep sleep,more proportion of light sleep,24 hours mean blood pressure and nocturnal blood pressure increase in the patients with Sleep Apnea Syndrome.The severity of Sleep Apnea Syndrome has a positive correlation with the severity of abnormal sleep architecture and the degree of blood pressure elevation.更多还原