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目的对男性高血压并阻塞性睡眠呼吸暂停综合征(OSAS)患者进行综合干预的效果分析。方法 36例男性高血压并OSAS患者,药物治疗16例,为对照组;结合生活方式干预20例,为观察组。随访6个月前后比较生活习惯,血液生化资料及动态血压,超声心动图,睡眠呼吸多导图参数变化。结果①干预后观察组患者吸烟、肥胖及高盐高脂饮食、饮酒率均降低,P﹤0.05。每周到达有效运动的患者增加,P﹤0.01。②干预后两组患者血压水平下降,P﹤0.05。③干预后观察组患者BMI及血TC、TG、LDL、Cr浓度明显下降,P﹤0.01。24 h尿总蛋白及微量白蛋白明显下降,IVST及SBPV、DBPV均变小,P﹤0.01。④干预后观察组患者夜间低通气指数、呼吸暂停低通气指数、呼吸暂停时间及夜间觉醒时间变小,P﹤0.05。结论综合干预治疗可有效减少男性高血压并OSAS患者的心血管危险因素,减轻心脏及肾脏靶器官损害。
Objective To analyze the effect of comprehensive intervention in patients with hypertension and obstructive sleep apnea syndrome (OSAS). Methods Thirty-six patients with hypertension and OSAS were randomly divided into control group (16 cases) and control group (20 cases). The living habits, blood biochemical data and ambulatory blood pressure, echocardiography, sleep apnea parameters were compared 6 months after follow-up. Results ① After the intervention, smoking, obesity and salt-high-fat diet and alcohol drinking rate decreased in the observation group (P <0.05). Patients who reached effective exercise weekly increased, P <0.01. ② The levels of blood pressure decreased in both groups after intervention, P <0.05. ③ After intervention, the concentrations of BMI, TC, TG, LDL and Cr in the observation group decreased significantly. The levels of urinary total protein and microalbumin decreased significantly at P <0.01.24 h, while the IVST, SBPV and DBPV decreased, P <0.01. ④In the observation group, the nocturnal hypoventilation index, apnea-hypopnea index, apnea time and nocturnal arousal time decreased, P <0.05. Conclusion The comprehensive intervention treatment can effectively reduce the cardiovascular risk factors of male patients with hypertension and OSAS and reduce the damage of target organs in heart and kidney.