摘要
Abstract
Objective To observe the impact of nasal continuous positive airway pressure ( nCPAP ) on blood pressure and brain natriuretic peptide ( BNP ) among hypertension patients with complicated obstructive sleep apnea - hypopnea syndrome ( OSAHS ) and morning blood pressure surge ( EMBPS ).Methods Polysomnography ( PSC ) and 24 - hour ambulatory hlood pressure monitoring ( ABPM ) were carried out in 34 hypertension patients with complicated moderate to severe OSAHS and EMBPS.These patients were divided into treatment group ( 20 cases ) and control group ( 14 cases ).The average systolic pressure ( AvSP ), average diastolic pressure ( AvDP ) , and mean arterial blood pressure ( MABP ) of morning blood pressure, the lowest sleep hlood pressure and EMBPS were recorded.Morning BNP levels were detected.Then the treatment group received a 5 day treatment of nCPAP.Both groups were examined for the above indices on the fifth day.Differences hetween the treatment group and the control group were analyzed.Results The AvSP [( 30.03 ±7.77 ) mm Hg]and MABP [( 24.61 ±8.19 ) mm Hg]of EMBPS, and the AvSP [( 150.47 ±14.08 ) mm Hg], AvDP [( 98.82 ±12.29 ) mm Hg]and MABP [( 115.40 ±11.98 ) mm Hg]of morning blood pressure declined remarkably after treatment [( 35.96 ±5.18 ), ( 29.18 ±6.76 ).( 159.59 ±11.53 ), ( 104.7 ± 10.48 ), ( 123.34 ± 9.76 ) mm Hg]in the treatment group ( P ＜ 0.05 ).Serum levels of BNP [( 721.025 ±99.382 ) pg/ml]in the treatment group declined remarkably after treatment in comparison with hefore [( 807.253 ± 110.537 ) pg/ml]( P ＜ 0.05 ).A positive correlation was noted between the decline of BNP and the decline of morning AvSP after treatment ( r = 0.540 , P ＜ 0.05 ).Conclusion These data suggest that OSAHS may contrihute to EMBPS.It is of significance to carry out nCPAP treatment in hypertension patients with complicated moderate or severe OSAHS.When blood pressure can not be controlled by medicine.it is better for PSG examination to be carried out for OSAHS screening.Moreover, BNP may participate in the regulation of EMBPS , which can be used in evaluating the severity and the therapeutic efficacy of EMBPS.关键词
高血压/血压晨峰/睡眠呼吸暂停/阻塞性/经鼻持续气道正压通气/脑钠肽Key words
Hypertension/ Early morning blood pressure surge / Sleep apnea, ohstructive/ Nasal continuous positive airway pressure / Brain natriuretic peptide分类
医药卫生
