伴睡眠呼吸暂停的高血压患者的降压疗效分析
摘要
目的观察睡眠呼吸暂停相关性高血压患者对不同降压药物治疗的效果。方法连续入选就诊门诊或住院的高血压患者,并对可疑有"睡眠呼吸暂停综合症"的患者,进行整夜睡眠呼吸监测(PSG),根据呼吸暂停低通气指数(AHI)筛选出患者共535人,完善相关生化检查、靶器官评估等检查,随机选用"拉西地平、厄贝沙坦"降压治疗,并依此分为2组;每2周随访1次,观察4周,最后共有96人完成全部随访。结果入选时2组患者在血压水平、以及睡眠呼吸暂停的程度等基线资料均无差异。第2周时,2组之间的达标率无差异(P>0.05),但较基线时压水平下降均有显著差异(P<0.05);第4周时,各组未达标患者的达标率无差异(P>0.05),但与第2周时血压相比有显著下降(P<0.05)。结论拉西地平和厄贝沙坦均显著降低睡眠呼吸暂停相关性高血压患者的血压,2组间的降压疗效未见明显差异。
引文
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[4]中国医师协会高血压专业委员会,中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停相关性高血压临床诊断和治疗专家共识[J].中华高血压杂志,2012,20(12):1119-1123.
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[6]Goodfriend TL,Galhoun DA.Resistant hypertension,obesity,sleep apnea,and aldosterone:theory and therapy[J].Hypertension,2004,43(3):518-524. Gottlieb DJ,Yenokyan G,Newman AB,et al.Prospectivestudy of obstructive sleep apnea and incident coronary heart disease and heart failure:the sleep heart health study[J].Circulation,2010,122:352-360.
[7]李莹,闫明,郭吉伟,等.睡眠呼吸暂停综合征与晨峰血压、心率关系的研究[J].哈尔滨医科大学学报,2014,48(1):44-47.
[2]Pedrosa RP,Drager LF,de PaulaLK,et al.Effects of OSA treatment on BP in patients with resistant hypertension:A randomized trial[J].Chest,2013,144(5):1487-1494.
[3]Martinez-Garcia MA,Capote F,Campos-Rodriguez F,et al.Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistanthypertension:TheHIPARCOrandomizedclinicaltrial[J].JAMA,2013,310(22):2407-2415.
[3]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.
[4]中国医师协会高血压专业委员会,中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停相关性高血压临床诊断和治疗专家共识[J].中华高血压杂志,2012,20(12):1119-1123.
[5]Ziegler MG.Sleep disorders and the failure to lower nocturnal blood pressure[J].Curr Opin Nephrol Hypertens,2003,12(1):97-102.
[6]Goodfriend TL,Galhoun DA.Resistant hypertension,obesity,sleep apnea,and aldosterone:theory and therapy[J].Hypertension,2004,43(3):518-524. Gottlieb DJ,Yenokyan G,Newman AB,et al.Prospectivestudy of obstructive sleep apnea and incident coronary heart disease and heart failure:the sleep heart health study[J].Circulation,2010,122:352-360.
[7]李莹,闫明,郭吉伟,等.睡眠呼吸暂停综合征与晨峰血压、心率关系的研究[J].哈尔滨医科大学学报,2014,48(1):44-47.