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投稿时间：2019-10-10 网络发布日期：2020-03-20
投稿时间：2019-10-10 网络发布日期：2020-03-20
中文摘要: 目的 探讨短期酒精摄入后对不同严重程度的阻塞性睡眠呼吸暂停(OSA)高血压人群睡眠参数及血压的改变。方法 选取2015年4月至2016年9月就诊于新疆维吾尔自治区人民医院高血压诊疗研究中心男性高血压患者61例。根据睡眠呼吸暂停低通气指数(AHI)将患者分为重度OSA组(AHI>30次/h,23例)和对照组(^AHI≤30次/h,38例)。分别在饮酒前后进行两次睡眠呼吸监测(PSG),并于饮酒前及饮酒后PSG前抽取静脉血进行酒精浓度测定。同时在两次PSG监测睡前及次日清晨监测血压水平变化。比较重度OSA组和对照组中短期酒精摄入后对睡眠参数及血压的改变。结果 重度OSA组饮酒后最低动脉血氧饱和度(LSaO2)、快速动眼睡眠时期、睡前收缩压、睡前舒张压较饮酒前降低,差异有统计学意义(P<0.05,P<0.01)。对照组饮酒后AHI、呼吸暂停指数(AI)、低通气指数(HI)较饮酒前升高,LSaO2、晨起舒张压较饮酒前降低,差异有统计学意义P<0.05,P<0.01)。重度OSA组饮酒前、后AHI、AI指数均高于对照组(P<0.01)。重度OSA组饮酒前HI指数高于对照组(P<0.01),饮酒后与对照组无统计学差异(P>0.05)。相关性分析显示,饮酒前后酒精浓度的改变与AI指数、睡前收缩压改变呈正相关(r=0.329,P=0.0 15;r=0.266,P=0.050)。多元线性回归分析显示,饮酒前后酒精浓度差值、LSaO2差值是AI指数改变的独立影响因素(P<0.01)。结论 短期酒精摄入会加重OSA相关高血压人群的睡眠紊乱程度,降低LSaO2，并降低重度OSA高血压人群的血压水平。
中文关键词: 阻塞性睡眠呼吸暂停综合证 高血压 最低血氧饱和度 睡眠呼吸监测 睡眠呼吸暂停低通气指数 呼吸暂停指数 低通气指数
Abstract:Objective To explore the impacts of short-term alcohol intake on sleep parameters and blood pressure in population with different severity of obstructive sleep apnea (OSA) related hypertension. Methods Sixty-one male patients with hypertension, admitting to hypertension diagnosis and treatment research center in Xinjiang People′s Hospital from April 2015 to September 2016, were selected. According to sleep apnea hypopnea index (AHI), the patients were divided into severe OSA group (AHI>30 times/h, n=23) and control group (AHI≤30 times/h, n=38). Before and after drinking, polysomnography (PSG)was performed, and venous blood was taken before drinking and before PSG after drinking to determine the alcohol concentration. At the same time, the changes of blood pressure were monitored before sleeping and in the next morning. The changes of sleep parameters and blood pressure were compared after short-term alcohol intake between two groups. Results In severe OSA group, the lowest arterial oxyhemoglobin saturation (LSaO2), rapid eye movement (REM) sleep period, pre-sleep systolic blood pressure and pre-sleep diastolic blood pressure decreased significantly compared with before drinking (P<0.05, P<0.01). In control group, AHI, apnea index (AI), hypoventilation index (HI) were higher than those before drinking, while LSaO2 and morning diastolic blood pressure(DBP) were lower than those before drinking (P<0.05, P<0.01). Before and after drinking, AHI and AI in severe OSA group were higher than those in control group (P<0.01); before drinking, HI was higher in severe OSA group than that in control group (P<0.01), but there was no significant difference in it between two groups after drinking (P>0.05). Correlation analysis showed that the change of alcohol concentration before and after drinking was positively correlated with the change of AI and pre-sleep systolic blood pressure (r=0.329, P=0.015; r=0.266, P=0.050). Multiple linear regression analysis showed that the differences in alcohol concentration and LSaO2 before and after drinking were the independent factors affecting the change of AI (P<0.01). Conclusion Short-term alcohol intake can aggravate the degree of sleep disorder, decrease LSaO2 in population with OSA-related hypertension and reduce the blood pressure level of hypertension with severe OSA.
keywords: Obstructive sleep apnea syndrome Hypertension Lowest arterial oxyhemoglobin saturation Polysomnography Sleep apnea hypopnea index Apnea index Hypoventilation index
文章编号： 中图分类号： 文献标志码：A
基金项目:国家自然科学基金(81650001)
附件
| Author Name | Affiliation |
| WANG Ying, YAO Xiao-guang, LI Nan-fang, HONG Jing | Graduate School of Xinjiang Medical University, Urumqi, Xinjiang 830054, China |
引用文本：
王瑛,姚晓光,李南方,等.酒精摄入对阻塞性睡眠呼吸暂停相关高血压人群睡眠及血压的影响[J].中国临床研究,2020,33(3):303-307.
王瑛,姚晓光,李南方,等.酒精摄入对阻塞性睡眠呼吸暂停相关高血压人群睡眠及血压的影响[J].中国临床研究,2020,33(3):303-307.