本文選題：阻塞性睡眠呼吸暫停低通氣綜合征　切入點(diǎn)：高血壓　出處：《廣西醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的研究阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea hypertension syndrome, OSAHS)高血壓患者動(dòng)態(tài)血壓特點(diǎn),尤其是早晨血壓高峰出現(xiàn)率及出現(xiàn)時(shí)間,并分析其相關(guān)因素。 方法選取2011年1月～2012年12月因打鼾在廣西壯族自治區(qū)人民醫(yī)院睡眠呼吸疾病診療中心行多導(dǎo)睡眠圖(polysomnography, PSG)檢測確診為OSAHS的18-65歲患者為對象,根據(jù)是否患有高血壓病將OSAHS患者分為OSAHS高血壓組、單純OSAHS組,在高血壓病門診選取無打鼾的高血壓病患者為對照1組(單純高血壓組),在體檢中心和我院職工中招募無打鼾無高血壓者為對照組2組(正常組)。分別對4組人群行24小時(shí)動(dòng)態(tài)血壓檢測并對其數(shù)據(jù)進(jìn)行分析,比較4組非杓型血壓、早晨血壓高峰出現(xiàn)率和出現(xiàn)的時(shí)間。 結(jié)果一、符合條件的213例受試者,平均年齡45.27±10.28歲,男性181例(84.9%),女性32例(15.1%)。其中OSAHS高血壓組44例(20.7%),單純OSAHS組115例(54.0%),單純高血壓組24例(11.3%),正常組30例(14.1%)。各組間年齡差異無統(tǒng)計(jì)學(xué)意義。頸圍OSAHS高血壓組、單純OSAHS組單純高血壓組、正常組,腰圍OSAHS高血壓組單純高血壓組、單純OSAHS組及正常組(P均0.05),單純OSAHS組腰圍對照組。體重指數(shù)(BMI) OSAHS高血壓組單純OSAHS組單純高血壓組正常組(P均0.05)。二、全天血壓變化：OSAHS高血壓組比較單純高血壓組全天收縮壓更高,以夜間收縮壓升高更為明顯。OSAHS組的夜間舒張壓正常組。三、OSAHS高血壓組非杓型血壓發(fā)生率為86.4%,OSAHS組為79.1%,高血壓組為45.8%,正常組為23.3%；OSAHS高血壓組早晨血壓高峰發(fā)生率為84.1%,OSAHS組為50.4%,單純高血壓組為37.5%,正常組為26.7%。早晨血壓高峰在OSAHS高血壓組5-6AM出現(xiàn)率最高,為86.4%；OSAHS組5-6AM出現(xiàn)率最高,為60.9%；單純高血壓組7-8AM出現(xiàn)率最高,為37.5%；正常組在早晨各時(shí)段出現(xiàn)率無差異。 結(jié)論OSAHS高血壓組與單純OSAHS組、單純高血壓組、正常組全天血壓變化規(guī)律存在差異,OSAHS高血壓組非杓型血壓及早晨血壓高峰發(fā)生率明顯增加,OSAHS高血壓組、單純OSAHS組早晨血壓高峰出現(xiàn)時(shí)間比單純高血壓組出現(xiàn)時(shí)間提前。
[Abstract]:Objective to study the characteristics of ambulatory blood pressure (ABP) in patients with obstructive sleep apnea hypertension syndrome (OSAHS), especially the occurrence rate and time of morning peak blood pressure, and to analyze the related factors. Methods Polysomnography (PSG) was performed in the diagnosis and treatment center of sleep apnea disease of Guangxi Zhuang Autonomous region people's Hospital from January 2011 to December 2012. The patients aged 18-65 years who were diagnosed with OSAHS were selected as subjects. OSAHS patients were divided into OSAHS hypertension group and simple OSAHS group according to whether they had hypertension. Hypertension patients without snoring were selected as control group (simple hypertension group) and those without snoring and hypertension were recruited in physical examination center and staff of our hospital as control group 2 (normal group). The group performed 24-hour ambulatory blood pressure testing and analyzed its data. The incidence and time of peak blood pressure in the morning were compared among 4 groups of non-dipper blood pressure. Results 1. The average age of 213 eligible subjects was 45.27 鹵10.28 years old. There were 44 cases of OSAHS hypertension group, 115 cases of simple OSAHS group, 24 cases of simple hypertension group, 24 cases of simple hypertension group and 30 cases of normal group. There was no significant difference in age between the two groups. There was no significant difference in age between the two groups. Normal group, waist circumference OSAHS hypertension group, simple OSAHS group and normal group (P 0.05), simple OSAHS group waist circumference control group, body mass index (BMI) OSAHS hypertension group simple OSAHS group simple hypertension group, normal group (P < 0.05). Full-day blood pressure changes: the whole day systolic blood pressure in the 10% OSAHS hypertension group is higher than that in the simple hypertension group. The incidence of non-dipper blood pressure in the OSAHS hypertension group was 79.1, that in the hypertension group was 45.8 percent, and that in the normal group was 23.3OSAHS hypertension group. The morning blood pressure peak rate was 84.1in the OSAHS hypertension group, 79.1in the OSAHS group, 45.8 in the hypertension group, and 23.3OSAHS hypertension group in the normal group. The morning blood pressure peak was the highest in the OSAHS hypertension group, and was the highest in the OSAHS hypertension group. The incidence of 5-6AM was the highest in the OSAHS group (60.9), the highest in the simple hypertension group (37.5%). There was no difference in the incidence of 5-6AM in the normal group. Conclusion there is a significant difference between OSAHS hypertension group and simple OSAHS group, simple hypertension group, normal group. The incidence of non-dipper blood pressure and morning blood pressure peak in OSAHS hypertension group is significantly higher than that in OSAHS hypertension group. The onset time of peak blood pressure in OSAHS group was earlier than that in simple hypertension group.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R766;R544.1

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