摘要
目的探讨睡眠呼吸暂停低通气综合征(sleep apnea syndrome,SAS)患者的临床特征、睡眠和生活质量、炎症因子水平及其与高血压的关系。方法 300例SAS患者(SAS组)和100例体检健康者(对照组),比较2组血压水平以及睡眠质量和生活质量评分;采用ELISA法检测2组外周血肿瘤坏死因子(tumor necrosis factor-alpha,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平。结果(1)SAS组超体质量及肥胖者比率(86.3%)高于对照组(55.0%)(P<0.05);肥胖者重度SAS发生率(82.76%)高于超体质量(58.77%)和体质量正常者(12.20%)(P<0.05);SAS组81.7%患者合并鼻咽部疾病;(2)SAS组睡前及晨醒后收缩压分别为(134.60±10.70)、157.40±1.09)mm Hg,舒张压分别为(85.30±7.80)、(112.40±13.20)mm Hg,对照组分别为(124.50±73.40)、(126.60±7.53)mm Hg和(76.20±6.60)、(81.30±6.90)mm Hg,2组比较差异有统计学意义(P<0.05);SAS组合并高血压者睡前及晨醒后收缩压[(148.00±17.05)、(170.70±19.75)mm Hg]、舒张压[(89.07±11.87)、(115.00±14.13)mm Hg]均高于未合并高血压者[(126.40±6.92)、(151.30±18.96)mm Hg,(80.03±7.14)、(110.10±15.72)mm Hg](P<0.05);(3)SAS组睡眠质量评分(4.1±1.3)低于对照组(8.9±2.4)(P<0.05);SAS组生活质量评分低于对照组(P<0.05);(4)SAS组血清TNF-α、IL-6、CRP分别为(15.7±6.4)ng/L、(13.4±6.1)ng/L、(7.9±3.2)μg/L,明显高于对照组[(5.6±1.2)ng/L、(4.7±1.6)ng/L、(2.4±1.9)μg/L](P<0.05)。结论肥胖及鼻咽部疾病为SAS的易感因素;SAS发生与高血压有关;SAS患者睡眠质量和生活质量均下降,血清炎症因子失衡与夜间反复多次发作呼吸暂停及低氧血症有关。
Objective To explore the clinical characteristics of sleep apnea syndrome（SAS）,sleep quality,life quality and the level of inflammatory factors,as well as their relationship with hypertension.Methods The blood pressure,sleep quality and life quality were compared between 300 patients with SAS（SAS group）and 100 healthy volunteers（control group）.ELISA technique was adopted to detect the levels of inflammatory factors as tumor necrosis factor-alpha（TNF-α）,interleukin-6（IL-6）and C-reactive protein（CRP）.Results The overweight and obesity rate was higher in SAS group（86.3%）than that in control group（55.0%）（P0.05）.The incidence of severe SAS was higher in obese patients（82.76%）than that in overweight patients（58.77%）and normal weight patients（12.20%）（P0.05）.In SAS group,81.7% patients were complicated with nasopharyngeal diseases.The systolic blood pressures（SBP）were（134.60±10.70）and（157.40±1.09）mm Hg,and diastolic blood pressures（DBP）were（85.30±7.80）and（112.40±13.20）mm Hg before sleeping and after awakening in SAS group,significantly different from those in control group（SBP：（124.50±73.40）,（126.60±7.53）mm Hg;DBP：（76.20±6.60）,（81.30±6.90）mm Hg）（P0.05）.SBP were（148.00±17.05）and（170.70±19.75）mm Hg and DBP were（89.07±11.87）and（11.50±14.13）mm Hg before sleeping and after awakening in patients complicated with hypertension,significantly higher than those in patients not complicated with hypertension in SAS group（P0.05）.There was significant difference in the sleep quality score between SAS group（4.1±1.3）and control group（8.9±2.4）（P0.05）.There was a significant difference in life quality score between two groups（P0.05）.The levels of TNF-α,IL-6and CRP were significantly higher in SAS group（（15.7±6.4）ng/L,（13.4±6.1）ng/L,（7.9±3.2）μg/L）than those in control group（（5.6±1.2）ng/L,（4.7±1.6）ng/L,（2.4±1.9）μg/L）（P0.05）.Conclusion Obesity and nasopharyngeal diseases are predisposing factors for SAS.SAS is associated with hypertension.Sleep quality and life quality are low in patients with SAS.The unbalanced level of serum inflammatory factors is correlated with repeated seizures of sleep apnea and hypoxia.
出处
《中华实用诊断与治疗杂志》
2015年第5期465-467,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
中华医学会慢性呼吸道疾病专项基金(2007年)(07010160024)
