文章摘要
黎燕群,张希龙.持续气道正压通气治疗对阻塞性睡眠呼吸暂停综合征患者难治性高血压的影响[J].南京医科大学学报,2008,28(2):210~214
持续气道正压通气治疗对阻塞性睡眠呼吸暂停综合征患者难治性高血压的影响
Efficacy of continuous positive airway pressure treatment to resistant hypertension in patients with obstructive sleep apnea syndrome
投稿时间:2007-08-28  
DOI:10.7655
中文关键词: 阻塞性睡眠呼吸暂停低通气综合征  难治性高血压  持续气道正压通气  醛固酮
英文关键词: obstructive sleep apnea syndrome  resistant hypertension  continuous positive airway pressure  aldosterone
基金项目:
作者单位
黎燕群 南京医科大学第一附属医院呼吸科,江苏 南京 210029 
张希龙 南京医科大学第一附属医院呼吸科,江苏 南京 210029 
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中文摘要:
      目的:通过观察持续气道正压通气(CPAP)对合并难治性高血压(RH)的阻塞性睡眠呼吸暂停综合征(OSAS)患者的血压和血浆醛固酮(ALD)?血浆肾素活性(PRA)的影响,以探讨CPAP治疗对OSAS合并RH患者血压的疗效及可能的机制?方法:选择13例合并RH的中重度OSAS患者,分别于CPAP治疗前及CPAP治疗3个月时测量和比较睡前(10:00PM)?夜间(02:00AM)和清晨(6:00AM)的血压及晨起(6:00AM)卧位血浆ALD?PRA水平,ALD?PRA检测采用放射免疫分析法?结果:与CPAP治疗前相比,CPAP治疗3个月时相比变化如下:睡前?夜间和清晨血压均显著下降(均为P < 0.01),其中收缩压比较为10:00PM时:(152.2 ± 19.2)mmHg vs(135.5 ± 2.8)mmHg,2:00AM时:(156.6 ± 19.4)mmHg vs(133.1 ± 2.4)mmHg,6:00AM时:(172.1 ± 23.7)mmHg vs(151.5 ± 3.0)mmHg;舒张压比较为10:00PM时:(98.9 ± 15.6) vs(84.2 ± 4.6)mmHg,2:00AM时:(102.8 ± 16.6)mmHg vs(81.5 ± 4.6)mmHg,6:00AM时:(50.9 ± 16.9)mmHg vs(50.7 ± 4.3)mmHg;晨起卧位ALD明显降低[(195.5 ± 15.1)ng/L vs(148.3 ± 19.4)ng/L,P < 0.01],但PRA无明显变化[(0.20 ± 0.12)μg/(L·h) vs(0.27 ± 0.14)μg/(L·h), P > 0.05)?结论:CPAP治疗可显著改善OSAS患者的RH并降低血浆ALD浓度?OSAS患者的RH可能与血浆ALD浓度增高有关?
英文摘要:
      Objective:To investigate the efficacy and possible mechanism of continuous positive airway pressure(CPAP) treatment on blood pressure in patients with obstructive sleep syndrome(OSAS) and resistant hypertension(RH). Methods:Thirteen OSAS patients with RH were recruited. Before and on three months’ CPAP treatment,their blood pressures at 10:00 PM,2:00 AM and 6:00 AM were measured,and their morning plasma concentrations of aldosterone(ALD) and plasma renin activity(PRA) were tested at supine position with radioimmonoassay. Results:Compared with blood pressure before CPAP treatment,there was a significant decrease in blood pressure after three months’ CPAP treatment(all P < 0.01). Comparison of plasma concentrations of ALD and PRA before and after three months’ CPAP treatment indicated that there was a significant difference in ALD[(195.5 ± 15.1)ng/L vs (148.3 ± 19.4)ng/L,P < 0.01] but not significantly different in PRA[(0.20 ± 0.12)μg/L·h vs(0.27 ± 0.14)μg/L·h,P = 0.221]. Conclusion:CPAP treatment could significantly improve RH and plasma ALD concentration. Plasma ALD concentration elevating was possibly involved in pathogenesis of RH in OSAS patients.
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