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目的评价持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者血压的影响。方法 OSAHS合并高血压患者86例,根据治疗方法的不同分为两组:CPAP组(n=46)和硝苯地平组(n=40)。分别于治疗前、服硝苯地平缓释片1周后、使用CPAP治疗1周后,行多导睡眠监测(PSG)和动态血压监测(ABPM),观察CPAP、硝苯地平缓释片的治疗效果,并进行分析比较。结果 CPAP、硝苯地平缓释片均能显著降低患者血压水平(均P<0.05),对降低夜间血压水平、改善昼夜血压节律(杓型血压比例),CPAP显著优于硝苯地平缓释片(均P<0.05),白天血压改善两者则相近(P>0.05)。结论对OSAHS合并高血压患者,CPAP通过改善通气,降低呼吸暂停低通气指数,提高血氧饱和度,既能有效治疗OSAHS,亦能显著改善高血压。
Objective To evaluate the effect of continuous positive airway pressure (CPAP) on blood pressure in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension. Methods Eighty-six patients with OSAHS complicated with hypertension were divided into two groups according to the treatment methods: CPAP group (n = 46) and nifedipine group (n = 40). One week after treatment with nifedipine and one week after treatment with nifedipine, respectively, polysomnography (PSG) and ambulatory blood pressure monitoring (ABPM) were performed after one week of treatment with CPAP. The treatment of CPAP and nifedipine sustained-release tablets Effect, and analysis and comparison. Results CPAP and nifedipine sustained-release tablets could significantly reduce the blood pressure (all P <0.05). CPAP was significantly superior to nifedipine sustained-release tablets in lowering nocturnal blood pressure and improving circadian rhythm (dipper blood pressure ratio) (Both P <0.05), while the improvement of blood pressure during the day was similar (P> 0.05). Conclusion In OSAHS patients with hypertension, CPAP can improve OSAHS and improve hypertension by improving ventilation, decreasing apnea hypopnea index and increasing oxygen saturation.