摘要
目的:探讨基于多导睡眠监测(PSG)的高血压病患者的睡眠特点,及与痰湿证候的关系。方法:收集行PSG的高血病(EH)患者88例,其中痰湿证72例、非痰湿证16例;非EH非高血压病组(non-EH)67例,指标包括总卧床时间(TIB)、总睡眠时间(TST)、睡眠效率(SE)、入睡潜伏期(SL)、快速眼动期占总睡眠时间比(REM/TST)、非快速眼动期占总睡眠时间比(NREM/TST)、脑电醒觉反应指数(ai)、呼吸暂停指数(AI)、低通气指数(HI)、呼吸暂停低通气指数(AHI)、平均氧饱和度(SM)、最低氧饱和度(SN)。结果:EH组内的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)占比高于非EH组(χ2=18.672,P<0.001)。EH组中重度OSAHS占比高于非EH组(χ2=21.727,P<0.001),两组间EH组的AI、HI、AHI、SE显著升高,而SM、SN、TIB显著降低(P<0.05)。高血压病痰湿证组OSAHS占比高于与非痰湿证组(χ2=9.456,P=0.002),痰湿证组中重度OSAHS占比高于非痰湿证组(χ2=18.652,P<0.001)。痰湿证组的AI、HI、AHI较非痰湿证显著升高,SM、SN显著降低(P<0.05)。Logistic回归分析:调整混杂因素后,OSAHS患EH的相对危险度(OR值)为4.693(95%CI[1.894,11.633],P=0.001)。结论:OSAHS是引起高血压病独立危险因素,临床上表现为痰湿证为主要特征。
Objective: To explore the relationship between sleep characteristics in hypertensive patients and phlegmdamp syndrome based on polysomnography. Methods: Eighty-eight patients with essential hypertension(EH) who have conducted polysomnography were collected in our hospital, among which there were 72 cases of phlegm-damp syndrome, 16 cases of non-phlegm-damp syndrome, while 67 cases of non-hypertensive patients were collected as control group at the same time. The observed indicators included time in bed(TIB), total sleep time(TST), sleep efficiency(SE), sleep latency(SL), rapid eye movement sleep/total sleep time(REM/TST), non-rapid eye movement sleep/total sleep time(NREM/TST), arousal index(ai), apnea index(AI), hypopnea index(HI), apnea hypopnea index(AHI), the SpO2 mean(SM) and SpO2 nadir(SN). Results: The percentage of obstructive sleep apnea hypopnea syndrome(OSAHS) in the EH group was higher than that in the non-EH group(χ2=18.672, P<0.001). The moderate to severe OSAHS in the EH group was higher than that in the nonEH group(χ2=21.727, P<0.001). Among the two groups, AI, HI, AHI and SE increased in EH group, but SM, SN and TIB decreased(P<0.05);OSAHS proportion in PDS group was higher than that in non-PDS group(χ2=9.456, P=0.002), and the proportion of moderate and severe OSAHS in PDS group was higher than that in non-PDS group(χ2=18.652, P<0.001). AI, HI and AHI in group PDS were higher than those in non-PDS, while SM and SN in PDS group decreased(P<0.05). Logisticregression analysis: After adjusting the confounding factors, the relative risk of EH in OSAHS was 4.693(95%CI[1.894, 11.633], P=0.001). Conclusion: OSAHS is an independent risk factor for hypertension, and the clinical manifestation is phlegm-damp syndrome.
作者
黄昉萌
曾辉
骆杰伟
吴永希
陈炜玮
魏世超
郑星宇
HUANG Fang-meng;ZENG Hui;LUO Jie-wei;WU Yong-xi;CHEN Wei-wei;WEI Shi-chao;ZHENG Xing-yu(Provincial Clinical Medical College, Fujian Medical University, Fuzhou 350001, China;Department of Traditional Chinese Medicine, Fujian Provincial Hospital, Fuzhou 350001, China;The Second Clinical Medical College, Fujian University of Chinese Medicine, Fuzhou 350001, China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2019年第1期310-315,共6页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
福建省医药卫生科技创新项目(No.2015-CX-4)
福建省卫生系统中青年骨干人才培养项目资助计划项目(No.2015-ZQN-ZD-7)~~
