摘要
目的调查睡眠呼吸暂停相关性高血压靶器官损害及相关临床情况的发生率及特征。方法在高血压住院患者中进行阻塞性睡眠呼吸暂停(OSA)筛查,根据睡眠呼吸紊乱指数(AHI),诊断为睡眠呼吸暂停相关性高血压(AHI≥5)者603例入选为病例组,进一步分为轻(AHI5～<15)、中(AHI15～<30)、重(AHI≥30)3组,AHI<5者为对照组。检测血生化指标,进行尿蛋白定性、24h尿蛋白定量及心脏超声、颈动脉超声、眼底检查。分析各组靶器官损害及相关临床情况的发生率。结果各病例组年龄及体质量指数(BMI)均高于对照组,重度组收缩压及舒张压高于对照组(均P<0.007)。中度及重度组的左心室肥厚及颈动脉硬化发生率均高于对照组(分别为16.1%、13.7%比,4.8%,42.8%、44.4%比26.9%,均P<0.007)。4组脑血管病、肾损害、冠状动脉性心脏病(冠心病)及眼底病变发生率差异无统计学意义(P>0.05)。以靶器官损害及多系统相关临床情况的数量评价靶器官损害严重程度,4组中无及分别伴1、2、3个靶器官损害的线性趋势检验:总变异:χ2=25.527,P=0.002,线性趋势检验:χ2=11.191,P=0.001,偏离线性回归分量:χ2=14.336,P>0.05。以伴0～1个和2个以上靶器官损害二分类为应变量进行逐步logistic回归显示中重度OSA增加2个以上靶器官损害的风险,优势比:1.50(1.10,2.04)。结论睡眠呼吸暂停相关性高血压靶器官损害发生率高于单纯高血压,其程度与OSA的严重性独立相关。
Objective To investigate the prevalence of target organ damage（TOD）and related clinical conditions in obstructive sleep apnea-related hypertension（OSA-RH）.Methods A total of 603 OSA-RH patients screened from the hypertensives according to apnea hypopnea index（AHI）were recruited and divided into 3 groups：mild（AHI 5-15）,moderate（AHI 15-30）and severe（AHI≥30）group.Subjects with AHI less than 5 served as control.All participants underwent echocardiogram,carotid ultrasound,serum biochemical and urine protein measuring.The prevalence of TOD was compared among groups.Results Gender,age,body mass index and blood pressure were different among groups.The prevalence of left ventricular hypertrophy（LVH）,carotid atherosclerosis（CA）were higher in moderates and severe than those in controls（16.1%,13.7% vs 4.8% for LVH and 42.8%,44.4% vs 26.9% for CA respectively,P0.007）,with no significant difference for cerebrovascular disease,renal damage,coronary disease and retinopathy.Linear trend test showed a linear correlation between OSA and severity of TOD determined by amounts of TOD and multiple organ disease（linear trend mutation;χ2=11.191,P=0.001）.Divided all cases into two groups according to amounts of TOD,binary logistic regression show that OSA related independently with TOD more than two（OR=1.50,95% CI 1.10-2.04）.Conclusion The prevalence of TOD were more often in OSA-RH than that in essential hypertension,and the severity of TOD may correlate independently with OSA.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2011年第7期642-646,共5页
Chinese Journal of Hypertension
基金
新疆维吾尔自治区科技成果转化专项资金项目资助(201154126)
关键词
阻塞性睡眠呼吸暂停
高血压
左心室肥厚
颈动脉硬化
脑血管病
Obstructive sleep apnea
Hypertension
Left ventricular hypertrophy
Coronary vascular disease
Carotid atherosclerosis
