| 盛志强,宋松松,王涛,等.高血压合并阻塞性睡眠呼吸暂停低通气综合征病人动脉硬化情况以及关联性分析[J].安徽医药,2025,29(1):63-68. |
| 高血压合并阻塞性睡眠呼吸暂停低通气综合征病人动脉硬化情况以及关联性分析 |
| Arteriosclerosis in patients with hypertension complicated with OSAHS and its correlation analysis |
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| DOI：10.3969/j.issn.1009-6469.2025.01.012 |
| 中文关键词: 高血压 阻塞性睡眠呼吸暂停低通气综合征 臂踝脉搏波速度 呼吸暂停低通气指数 动脉硬化 |
| 英文关键词: Hypertension Obstructive sleep apnea hypopnea syndrome Brachial-ankle pulse wave velocity Apnea-hypopnea index Arteriosclerosis |
| 基金项目:江苏省自然科学基金项目( BK20211167) |
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| 中文摘要: |
| 目的探讨高血压和阻塞性睡眠呼吸暂停低通气综合征( OSAHS)疾病对病人自身动脉硬化情况的影响，以及分析动脉硬化与高血压分级、睡眠呼吸相关参数以及心血管疾病高危因素之间的相关性。方法选取 2020年 10月至 2021年 12月就诊于东南大学附属中大医院并行睡眠呼吸监测病人，依据诊断将其分为无高血压无 OSAHS组 24例(对照组)、无高血压有 OSAHS组 35例(单 OSAHS组)、有高血压无 OSAHS组 53例(单 HBP组)、高血压合并 OSAHS组 92例(双阳组)。比较四组间臂踝脉搏波速度( baPWV)；同时根据 baPWV>1 800 cm/s为界判断 baPWV是否异常作为因变量进行多因素非条件 logistic回归分析。结果高血压合并 OSAHS组(双阳组) baPWV(1 952.70±466.75)cm/s明显大于单纯高血压组( 1 664.96±306.52)cm/s、单纯 OSAHS组( 1 710.29±440.61)cm/s以及对照组( 1 379.63±209.46)cm/s；单纯高血压组、单纯 OSAHS组 baPWV也大于对照组；单纯高血压组与单纯 OSAHS组之间 baPWV差异无统计学意义( P>0.05)；在以 baPWV异常作为因变量的动脉硬化多因素非条件 logistic回归中显示年龄、呼吸暂停低通气指数( AHI)分级、血压分级、糖化血红蛋白是臂踝脉搏波速度增加的危险因素，与高血压年限、性别、最低血氧饱和度等无明显相关性。结论高血压及 OSAHS与早期动脉硬化指标的变化明显相关，同时 AHI以及血压水平越高，早期动脉硬化指标异常越明显；在高血压人群中因 OSAHS的存在动脉硬化程度明显异常，在高血压人群中早期筛查及干预 OSAHS可能有效减缓动脉硬化的发展。 |
| 英文摘要: |
| Objective To investigate the effects of hypertension and obstructive sleep apnea hypopnea syndrome (OSAHS) on pa-tients' arteriosclerosis and to analyze the correlation between arteriosclerosis and hypertension grade, parameters related to sleepbreathing, and risk factors for cardiovascular disease.Methods Patients admitted to the Department of Cardiology and Jiangbei Hospi-tal of Zhongda Hospital Affiliated to Southeast University from October 2020 to December 2021 for sleep breathing monitoring were se-lected. According to the diagnosis, the patients were assigned into 24 cases without hypertension and OSAHS (control group), 35 caseswithout hypertension and OSAHS (single OSAHS group), 53 cases with hypertension and OSAHS (single HBP group), and 92 caseswith hypertension and OSAHS (double positive group). The difference in brachial and ankle pulse wave velocity (baPWV) among thefour groups was compared. At the same time, baPWV > 1 800 cm/s was used as the boundary to determine whether baPWV was abnor-mal or not. Multivariate unconditional logistic regression analysis was performed as the dependent variable. Results baPWV (1952.70±466.75) cm/s of hypertension combined with OSAHS (double positive group) was significantly higher than that of hypertensionalone (1 664.96±306.52) cm/s, OSAHS alone (1 710.29±440.61) cm/s and control group (1 379.63±209.46) cm/s. baPWV of pure hy-pertension group and OSAHS group was higher than that of control group. There was no significant difference in baPWV between sim-ple hypertension group and simple OSAHS group (P > 0.05). Multivariate logistic regression with baPWV abnormality as dependentvariable showed that age, apnea hypopnea index (AHI) grade, blood pressure grade and HBA1c were risk factors for increased baPWV. There was no significant correlation with years of hypertension, gender, minimum oxygen saturation and so on. Conclusions Hyper-tension and OSAHS are significantly related to the changes of early atherosclerosis indicators. Meanwhile, the higher the AHI andblood pressure level, the more obvious the abnormalities of early atherosclerosis indicators. Early detection and control of hypertensioncan delay the changes of atherosclerosis indicators. Due to the existence of OSAHS, the degree of arteriosclerosis in hypertensive popu-lation is obviously abnormal. Early screening and intervention of OSAHS in hypertensive population may effectively slow down the de-velopment of arteriosclerosis. |
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