我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

阻塞性睡眠呼吸暂停低通气综合征对高血压Ⅰ级患者进驻高原后血压的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2017年第5期
页码:
552-555,562
栏目:
临床研究
出版日期:
2017-03-25

文章信息/Info

Title:
Effect of obstructive sleep apnea hypopnee syndrome on blood pressure in first stage hypertension patients stationing in plateau region
作者:
剡冬冬; 焦丕奇; 荆 哲; 郭文昀; 陈永清
（兰州军区兰州总医院心血管内科，甘肃 兰州 730050）
Author(s):
YAN Dong-dong;  JIAO Pi-qi;  JING Zhe;  GUO Wen-yun;  CHEN Yong-qing
(Department of Cardiology, Lanzhou General Hospital, Lanzhou Military Area Command, Lanzhou 730050, Gansu, China)
关键词:
高原; 高血压Ⅰ级; 阻塞性睡眠呼吸暂停综合征; 血氧饱和度
Keywords:
plateau area;  Hypertension LevelⅠ;  Obstructive sleep apnea syndrome;  OSAHS;  blood oxygen saturation
分类号:
R544.1
DOI:
-
文献标识码:
A
摘要:
目的 研究阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）对于短期进驻高原地区驻训的高血压Ⅰ级青年官兵血压的影响，并分析其机制。方法 试验组测定9名高血压Ⅰ级并发OSAHS青年官兵的基础血压和高原驻训期间（10，30和60 d）血压、心率，并采集相应时间点外周血氧饱和度(SO2)、睡眠时间、睡眠呼吸暂停低通气指数(apnea-hypopnea index,AHI)、神经内分泌激素〔肾素-血管紧张-醛固酮系统(RAAS)、皮质醇〕；对照组测定4名高血压Ⅰ级无OSAHS青年官兵的基础血压和高原驻训期间（10，30和60 d）血压、心率，并采集相应时间点SO2、睡眠时间、AHI、神经内分泌激素（RAAS、皮质醇）。结果 试验组官兵进驻高原后收缩压和舒张压均较基线水平显著升高（P<0.05），以舒张压升高为主。SO2下降显著（P<0.05），睡眠时间显著缩短（P<0.05），AHI显著增加（P<0.05），神经内分泌激素水平（RAAS及皮质醇）显著升高（P<0.05）。对照组官兵进驻高原前后血压、外周血SO2、睡眠时间、AHI及神经内分泌激素均无显著差异。结论 高原地区可导致高血压Ⅰ级的青年患者短时间血压持续升高，其机制可能与OSAHS引起血SO2下降、睡眠时间缩短、AHI增加及神经内分泌系统激活相关。
Abstract:
AIM To investigate the effect of obstructive sleep apnea hypopnee syndrome (OSAHS) on the blood pressure of young servicemen with first stage hypertension encamping on plateau for a short period and analyze the underlying mechanisms. METHODS Thirteen servicemen with hypertension were divided into two groups, 9 with OSAHS in OSAH group and 4 without OSAHS in control group. Blood pressure, peripheral blood oxygen saturation (SO2%), sleep time (h), apnea index (AHI) and neuroendocrine hormone (RAAS, cortisol) were collected at 10 d, 30 d and 60 d. RESULTS After stationing in the plateau region, systolic blood pressure and diastolic blood pressure in OSAHS group were significantly higher than the baseline (P<0.05), especially diastolic blood pressure. Blood oxygen saturation decreased significantly (P<0.05). Sleep time was significantly shorter (P<0.05), AHI significantly increased (P<0.05) and neuroendocrine hormone levels (renin-angiotensin-aldosterone system and cortisol) also increased (P<0.05). But no such significant differences were found in control group. CONCLUSION Encamping in plateau areas can lead to short-time exacerbation of hypertension. The mechanism may be related to OSAHS, which activates RAAS and stress hormone, resulting in more severe hypertension.

参考文献/References

[1] Parati G,Lombardi C.Recommendations for the management of patients with obstructive sleep apnoea and hypertension[J].Eur Respir J,2013,41(5):523-538.
[2]车晓文,许伟华,冯慧伟,等.阻塞性睡眠呼吸暂停低通气综合征调查[J].医学信息,2011,24(7):4125-4126.
[3]国家心血管病中心.中国心血管病报告2014[M].北京:中国大百科全书出版社,2014.
[4]Alajmi M,Mulgrew AT,Fox J,et al.Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea:a meta-analysis of randomized controlled trials[J].Lung,2007,185(2):67-72.
[5]Good friend TL,Calboun DA.Resistant hypertension obesity sleep apnea and aldosterone:theory and therapy[J].Hypertension,2004,43(3):518-524.
[6]Johnson PL,Edwards N,Burgess KR,et al.Sleep architecture changes during a trek from 1400 to 5000 m in the Nepal Himalaya[J].J Sleep Res,2010,19(1 Pt 2):148-156.
[7]Bloch KE,Latshang TD,Turk AJ,et al.Nocturnal periodic breathing during acclimatization at very high altitude at Mount Muztagh Ata(7546 m)[J].Am J Respir Crit Care Med,2010,182(4):562-568.
[8]Mees K,de la Chaux R. Polygraphy of sleep at altitudes between 5300 m and 7500 m during an expedition to Mt.Everest(MedEx 2006)[J].Wilderness Environ Med,2009,20(2):161-165.
[9]中华医学会呼吸学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-18.
[10]陈桂英,周立君,田 野.睡眠呼吸暂停与心血管疾病的研究进展[J].中国循环杂志,2010,25(5):397-399.
[11]林其昌,时玲燕,黄建钗,等.阻塞性睡眠呼吸暂停低通气综合征患者血管内皮生长因子的表达及其意义[J].中华老年医学杂志,2010,29(11):908-911.
[12]Lin M,Zheng Y,Hui R.The relationship of sleep duration and insomnia to risk of hypertension incidence:a meta-analysis of prospective cohort studies[J].Hypertens Res,2013,36(11):985-995.
[13]Te Riet L,van Esch JH,Roks AJ,et al.Hypertension: renin-angio-tensin-aldosterone system alterations[J].Circ Res,2015,116(6):960-975.
[14]李莉,吴海英,刘力生.睡眠呼吸暂停综合征与高血压治疗[J].中华心血管病杂志,2004,32(1):30-32.
[15]刘东亮,董彩艳.阻塞性睡眠呼吸暂停低通气综合征与临床高血压关系[J].实用诊断与治疗杂志,2015,19(2):137-138.
[16]赵小华，牛 津，阎威，等.高原高寒地区短期驻训对官兵血压的影响[J].心脏杂志,2016,28(1):128-F003.

备注/Memo

备注/Memo:
收稿日期：2016-10-23.
通讯作者：陈永清，主任医师，主要从事高原高血压研究 Email：chyqmd@163.com
作者简介：剡冬冬，主治医师 Email：yandongdong8@163.com
更新日期/Last Update: 2017-04-20