首页|肥胖阻塞性睡眠呼吸暂停综合征患者发生高血压的影响因素

肥胖阻塞性睡眠呼吸暂停综合征患者发生高血压的影响因素

Influencing factors of hypertension in obese patients with obstructive sleep apnea syndrome

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目的:本研究旨在探讨肥胖阻塞性睡眠呼吸暂停综合征(OSAS)患者合并高血压的临床特征及相关影响因素.方法:回顾性选取2020年1月~2022年9月在武汉科技大学附属天佑医院就诊并确诊为肥胖OSAS的患者201例,其中合并高血压者100例作为高血压组,未合并高血压者101例作为对照组.依据呼吸暂停低通气指数(AHI),将所有肥胖OSAS患者分为轻度OSAS组(n=36)、中度OSAS组(n=48)以及重度OSAS组(n=117),收集各组一般资料、血生化、心脏彩超及多导睡眠监测(PSG)指标.采用Pearson相关性分析法分析肥胖OSAS患者的血压与OSAS相关指标的相关性;采用多因素Logistic回归分析肥胖OSAS患者发生高血压的影响因素.结果:与对照组比较,高血压组的年龄、合并2型糖尿病(T2DM)、冠心病及中度OSAS占比、收缩压(SBP)、舒张压(DBP)、脂蛋白a[Lp(a)]、尿酸(UA)、空腹血糖(FPG)、高敏C反应蛋白(hsCRP)、左房内径(LAD)、最低血氧饱和度(LSO2)均显著升高,重度OSAS占比、AHI均显著降低(P<0.05或<0.01).Pearson相关性分析结果显示,肥胖O SAS患者的SBP、DBP与AHI呈负相关(r=-0.177,P=0.035;r=-0.189,P=0.024).多因素 Logistic 回归分析结果显示,年龄(OR=1.073,95%CI 1.017~1.133,P=0.010)、T2DM(OR=2.752,95%CI 1.245~6.082,P=0.011)、UA(OR=1.011,95%CI 1.001~1.021,P=0.031)、SBP(OR=1.313,95%CI 1.168~1.475,P<0.001)、DBP(OR=1.304,95%CI 1.154~1.474,P<0.001)是肥胖OSAS患者发生高血压的独立危险因素.结论:年龄、T2DM、UA、SBP、DBP是肥胖OSAS患者发生高血压的独立危险因素,临床上可以通过检测此类患者上述指标,及早发现和治疗高血压.
Objective:This study aimed to investigate the clinical characteristics and related influencing factors of obese patients with obstructive sleep apnea syndrome(OSAS)and hypertension.Methods:A total of 201 obese OS-AS patients who admitted and were diagnosed in Tianyou Hospital Affiliated to Wuhan University of Science & Tech-nology between January 2020 and September 2022 were retrospectively selected,the 100 cases complicated with hy-pertension were treated as hypertension group and 101 cases without hypertension were regarded as control group.According to apnea hypopnea index(AHI),all obese OSAS patients were divided into mild OSAS group(n=36),moderate OSAS group(n=48)and severe OSAS group(n=117).General data,blood biochemical indexes,cardiac color ultrasound and polysomnography(PSG)indexes were collected in all groups.Correlation between blood pres-sure and OSAS-related indexes in obese OSAS patients was analyzed by Pearson correlation analysis.Multivariate Logistic regression was used to analyze influencing factors of hypertension in obese OSAS patients.Results:Com-pared with those in control group,patients in hypertension group had significant higher age,proportions of type 2 diabetes mellitus(T2DM),coronary heart disease and moderate OSAS,systolic blood pressure(SBP),diastolic blood pressure(DBP),lipoprotein a[Lp(a)],uric acid(UA),fasting plasma glucose(FPG),high sensitive C re-active protein(hsCRP),left atrial diameter(LAD)and lowest oxygen saturation(LSO2),and significant lower proportion of severe OSAS and AHI(P<0.05 or<0.01).Pearson correlation analysis indicated that SBP and DBP were inversely correlated with AHI in obese OSAS patients(r=-0.177,P=0.035;r=-0.189,P=0.024).Multivariate Logistic regression showed that age(OR=1.073,95%C1 1.017~1.133,P=0.010),T2DM(OR=2.752,95%CI 1.245~6.082,P=0.011),UA(OR=1.011,95%CI 1.001~1.021,P=0.031),SBP(OR=1.313,95%CI 1.168~1.475,P<0.001)and DBP(OR=1.304,95%CI 1.154~1.474,P<0.001)were independent risk factors for hypertension in obese OSAS patients.Conclusion:Age,T2DM,UA,SBP and DBP are independent risk factors for hypertension in obese OSAS patients.Clinical staff can early identify and treat hypertension by detecting above-mentioned indexes.

HypertensionSleep Apnea,obstructiveObesity

喻巧园、李婧、程子敏、马丽

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武汉科技大学附属天佑医院心内科,武汉湖北 430064

高血压 睡眠呼吸暂停,阻塞性 肥胖

2024

心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子:1.157
ISSN:1008-0074
年,卷(期):2024.33(6)