论文部分内容阅读
目的探讨睡眠期阻塞性呼吸暂停综合征（ＳＯＡＳ）病人手术治疗和高血压的关系。方法测定ＳＯＡＳ患者手术前后血压、血氧饱和度（ＳａＯ２）、２４ｈ尿中肾上腺素（Ｅ）和去甲肾上腺素（ＮＥ）。结果ＳＯＡＳ伴高血压病人手术后血压明显下降，而ＳａＯ２上升，两者存在负相关（手术前后收缩压和舒张压与ＳａＯ２的相关系数分别为－０．７４和－０．７８，Ｐ＜０．０１）。成人鼾症伴ＳＯＡＳ患者手术前２４ｈ尿中Ｅ和ＮＥ测定值分别为２６．７４±１８．７４μｇ，１９５．７２±４８．３２μｇ，比正常值高，术后Ｅ和ＮＥ下降，并与ＳａＯ２上升存在负相关（手术前后Ｅ和ＮＥ与ＳａＯ２的相关系数分别为－０．４０和－０．４４，Ｐ＜０．０５）。结论ＳＯＡＳ和高血压有关，直接原因可能是ＳＯＡＳ患者睡眠期缺氧，刺激交感神经兴奋，儿茶酚胺释放增加，引起血压升高。治疗ＳＯＡＳ对某些伴ＳＯＡＳ高血压病人有一定临床意义。
Objective To investigate the relationship between surgical treatment and hypertension in patients with obstructive sleep apnea syndrome (SOAS). Methods The blood pressure, oxygen saturation (SaO2), urinary epinephrine (E) and norepinephrine (NE) in SOAS patients before and after operation were measured. Results The blood pressure of SOAS patients with hypertension decreased significantly after operation, while SaO2 increased. There was a negative correlation between them (the correlation coefficients of systolic and diastolic blood pressure and SaO2 before and after surgery were -0.74 and -0.78, respectively, P <0. 01). The values of urinary E and NE of adult snoring patients with SOAS before surgery were 26.74 ± 18.74μg and 195.72 ± 48.32μg respectively, higher than normal values, decreased E and NE, and increased with SaO2 (Correlation coefficients of E and NE with SaO2 before and after surgery were -0.40 and -0.44 respectively, P <0.05). CONCLUSIONS: SOAS is associated with hypertension. The direct cause may be hypoxia during sleep, stimulation of sympathetic nerves and increase of catecholamine release in SOAS patients, resulting in hypertension. Treatment of SOAS some patients with SOAS have some clinical significance.