伴高血压的阻塞性睡眠呼吸暂停低通气综合征的危险因素探索与分析

Risk factors for obstructive sleep apnea-hypopnea syndrome with hypertension

摘要:

目的 回顾性分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者的临床相关指标，以期发现此类患者的危险因素，为该类患者的治疗提供指导。方法 选取2017年1月—2021年12月行多导睡眠监测(PSG)的成人OSAHS患者共324例，其中伴高血压患者129例；采用Spearman秩相关系数和Logistic模型逐步回归对比分析呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO₂)、平均血氧饱和度(MSaO₂)、氧减指数、性别、年龄、病程、身高、体重、体质指数(BMI)、吸烟史、饮酒史、糖尿病病史、尿酸、空腹血糖、糖化血清蛋白、低密度脂蛋白、高密度脂蛋白、胆固醇、甘油三酯、血常规、凝血功能在OSAHS伴高血压组和单纯组之间的差异及其和高血压发生的相关性。结果 相关性分析显示AHI、年龄、病程、糖尿病病史、中性粒细胞计数/淋巴细胞计数(NLR)、尿酸、血糖、糖化血清蛋白、甘油三酯、胆固醇、纤维蛋白原、体重、BMI与OSAHS伴高血压呈正相关(P<0.05)，LSaO₂、MSaO₂、凝血酶原时间、活化部分凝血活酶时间与伴高血压呈负相关(P<0.05)。氧减指数、红细胞计数、白细胞计数、血小板计数等与OSAHS伴高血压无明显相关性(P>0.05)。回归分析显示LSaO₂、年龄、病程、BMI、糖化血清蛋白、凝血酶原时间为OSAHS相关性高血压的危险因素。结论 OSAHS相关性高血压在OSAHS人群中的患病率随病程的增加而升高，病程、年龄、BMI和LSaO₂是预测OSAHS相关性高血压的有效指标，在OSAHS的临床诊治中应提前进行预警和干预。

关键词:睡眠呼吸暂停低通气综合征;高血压;病程

Abstract:

Objective To find out the risk factors of obstructive sleep apnea-hypopnea syndrome (OSAHS) with hypertensive and provide guidance for the treatment via retrospective analysis of related clinical indexes.Methods A total of 324 adult patients with OSAHS who underwent polysomnography (PSG) from Jan 2017 to Dec 2021 were enrolled, including 129 patients with concomitant hypertension. Spearman rank correlation coefficient and Logistic model stepwise regression were used to compare and analyze apnea hypoventilation index (AHI), lowest oxygen saturation (LSaO₂), and mean oxygen saturation (MSaO2), oxygen desaturation index, gender, age, disease course, height, weight, body mass index (BMI), smoking history, drinking history, diabetes history, neutrophil/lymphocyte ratio, uric acid, fasting blood glucose, glycated serum protein, low-density lipoprotein, high-density lipoprotein, cholesterol, triglycerides, blood routine, and coagulation function. Their differences between the hypertensive group and non-hypertensive group and correlations with the occurrence of hypertension were compared and analyzed.Results Correlation analysis showed that AHI, age, duration, diabetes history, uric acid, blood glucose, glycosylated serum protein, triglycerides, cholesterol, fibrinogen, body weight, BMI were positively correlated with OSAHS-associated hypertension (P<0.05), while LSaO₂,MSaO₂, prothrombin time, activated partial thromboplastin time were negatively correlated with OSAHS-associated hypertension (P<0.05). There was no obvious correlation between oxygen reduction index, red blood cell count, white blood cell count, and platelet count with OSAHS-associated hypertension (P>0.05). Regression analysis showed that LSaO₂, age, disease course, BMI, glycated serum protein, and prothrombin were risk factors for OSAHS-associated hypertension.Conclusions The prevalence of OSAHS-associated hypertension in the population of OSAHS increases with the increase of the course of the disease. The course of the disease, age, BMI and LSaO₂ are effective indicators for predicting OSAHS-related hypertension, and early warning and intervention should be carried out in the clinical diagnosis and treatment of OSAHS.

Key words:Sleep apnea hypopnea syndrome;Hypertension;Course of disease