【摘要 】 目的 明确阻塞性睡眠呼吸暂停综合征(OSAS)患者清醒及睡眠时血压变化情况及对其影响的相关因素。方法 13例OSAS患者在桡动脉内留置导管监测血压并同步进行夜间睡眠多导生理仪连续记录,部分患者观察吸氧或经鼻(面)罩持续正压通气(NCPAP)的治疗效果。结果 (1)OSAS患者白天高血压发生率为46%(6/13)；白天无高血压的患者夜间一过性高血压发生率为86%(6/7)；(2)OSAS患者夜间血压增高与低氧血症和呼吸暂停时间有关，与呼吸暂停指数(AI)无相关性(P>0.05)；(3)2例OSAS患者经吸氧治疗后,夜间血压波动仍存在,高血压未得到纠正;4例OSAS患者经NCPAP治疗后,夜间血压波动消失。结论 白天无高血压的OSAS患者夜间可反复出现一过性血压增高；OSAS患者夜间血压增高与低氧血症、呼吸暂停时间有关，但低氧血症不是引起夜间血压增高的主要因素；单纯吸氧不能纠正OSAS患者夜间血压增高,NCPAP是纠正OSAS患者夜间血压增高的较好方法。

The occurrence of hypertension inpatients with obstructive sleep apnea syndrome Xiao Dan,Kang Jian,Wang Qiuyue,et al.Institute of RespiratoryDisease,China Medical University,Shenyang 110001

【Abstract 】 Objective Todetermine the changes in blood pressure (BP) and its correlated factors in patients withobstructive sleep apnea syndrome(OSAS). Method Retaining manometric tube in radial artery and polysomnography(PSG)were done synchronously in 13 patients with OSAS in whom was diagnosed by whole-night PSG.Oxygen therapy was given to two of the patients and NCPAP treatment was given to four ofthe patients on the following night. Result (1) Six of the patients (46 percent ) had daytime hypertension (SBP>18.7 kPa and/or DBP>12kPa), the incidence of transient hypertension duringapnea in 7 patients who do not have daytime hypertension was 86% (6/7) . (2)Lowest oxygensaturation during sleep was significantly correlated with the level of SBP(r=-0.659,P<0.05) and DBP(r=-0.677,P<0.01) in awake, the baseline of SBP(r=-0.777,P<0.01) and DBP (r=-0.590,P<0.05) in NREM sleep and that of SBP(r=-0.585,P<0.05) in REM sleep. In REM sleep, the changes in MBP showedsignificantly correlation with the changes in oxygen saturation during apnea(r=0.598,P<0.05). In NREM sleep, the changes in SBP were significantly correlated withapnea length(r=0.580,P<0.05). The changes in BP showed no correlation with apnea indexin different sleep stages (P>0.05). (3) Nocturnal elevation in BP disappeared in fourpatients who received NCPAP treatment,but not in two patients who received oxygen therapy.Conclusion The transienthypertension during apnea might be recurrent episodes in patients with OSAS who havenormal daytime BP.Nocturnal hypoxemia and apnea length might play a role in nocturnalelevation in BP in patients with OSAS.Hypoxemia was not the major factor in BP elevationafter obstructive apneas. Simple oxygen administration could not normalize the elevationin BP during apnea in patients with OSAS and NCPAP might be an appropriate therapy.

     【Key words 】 Sleep apnea syndromes Bloodpressure

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