摘要
背景阻塞性睡眠呼吸暂停(OSA)患病率高,已成为严重影响公众健康的疾病。OSA引起高血压及糖尿病可能存在民族差异,目前关于维吾尔族及汉族OSA患者高血压及糖尿病发病情况的研究较少。目的探讨汉族及维吾尔族OSA患者高血压及糖尿病发病情况。方法2010年10月—2017年10月对克拉玛依市区天山等社区35岁以上完成便携式家庭睡眠仪监测的1331例鼾症人群开展为期7年的随访,患者均无糖尿病及高血压。收集患者一般情况,记录呼吸暂停指数(AHI)、低通气指数(HI)、夜间最低氧饱和度(LSaO_(2))、夜间平均氧饱和度(MSaO_(2))、氧减饱和指数(ODI4,每小时血氧饱和度下降4%的次数)。电话随访,1次/年,随访内容为血压、血糖等,发现存在高血压、糖尿病表现时行动态血压、糖耐量试验检查,主要随访终点事件为确诊糖尿病、高血压。根据是否患OSA分为OSA组和非OSA组,比较两组高血压、糖尿病发生率;比较汉族、维吾尔族OSA患者和非OSA患者高血压、糖尿病发生率。结果失访75例,最终纳入1256例,平均年龄(58±13)岁,其中男532例(42.4%),女724例(57.6%);确诊OSA患者820例,其中汉族470例,维吾尔族350例;其余436例为非OSA患者,其中汉族164例,维吾尔族272例。随访结束时OSA组高血压发生率高于非OSA组(P<0.05);维吾尔族OSA患者高血压发生率高于非OSA(P<0.05);OSA组糖尿病发生率与非OSA组比较,差异有统计学意义(P<0.05);汉族OSA与非OSA糖尿病发生率比较,差异无统计学意义(P>0.05);维吾尔族OSA与非OSA糖尿病发生率比较,差异无统计学意义(P>0.05);汉族及维吾尔族OSA患者糖尿病发生率比较,差异无统计学意义(P>0.05)。结论OSA患者高血压发生率较一般人群高,睡眠呼吸暂停可引起高血压、糖尿病,汉族OSA患者高血压发生率高于维吾尔族,需积极早期干预治疗。
Background Obstructive sleep apnea(OSA)is highly prevalent,which has become a serious disease affecting public health.There are little data comparing the incidence of hypertension and diabetes in Uygur and Han people with OSA,which we assume to be different.Objective To perform a comparative analysis of the incidence of hypertension and diabetes in Han and Uygur people with OSA.Methods This prospective study was conducted from October 2010 to October 2017.Participants(n=1331)were Han and Uygur Chinese snorers aged more than 35 years with no hypertension and diabetes prior to the study who were selected from Tianshan Community,Karamay.All of them received an annual telephone follow-up in each of the seven years,for investigating the incidence of hypertension and/or diabetes,and the results of ambulatory blood pressure monitoring and oral glucose tolerance test performed when having clinical manifestations of hypertension and diabetes.The primary endpoint was diabetes and/or hypertension.General demographics,and parameters of portable home sleep test(apnea-hypopnea index,hypopnea index,lowest oxygen saturation,and mean oxygen saturation during sleep,and the number of 4%desaturations)were collected.The incidence of hypertension and/or diabetes was compared by OSA(assessed by the portable home sleep test)in all participants,in Han people,and Uygur people,and by OSA and ethnic group in participants.Results All cases were included for final analysis〔including 532(42.4%)men and 724(57.6%)women with a mean age of(58±13)years〕except for 75 missed cases.820 cases(470 Han and 350 Uygur people)were diagnosed with OSA,and 436(164 Han and 272 Uygur people)without.By the end of the follow-up,compared with those without OSA,participants with OSA had higher incidence of hypertension(P<0.05).Uygur people with OSA had higher incidence of hypertension than those without(P<0.05).The incidence of diabetes differed significantly between participants with and without OSA(P<0.05).But the difference in the incidence of diabetes was not significant between Han people with and without OSA,Uygur people with and without OSA,and Han and Uygur people with OSA(P>0.05).Conclusion Both Han and Uygur people with OSA were more likely to suffer from hypertension.OSA may be an independent risk factor for hypertension and diabetes.Han people with OSA were more prone to hypertension than Uygur counterparts,so early and aggressive intervention is needed.
作者
蒋雪龙
陈冬梅
王勤
张庆龙
李剑平
石娟
李敏
何忠明
韩芳
陈燕
JIANG Xuelong;CHEN Dongmei;WANG Qin;ZHANG Qinglong;LI Jianping;SHI Juan;LI Min;HE Zhongming;HAN Fang;CHEN Yan(Department of Respiratory and Critical Care Medicine,Karamay Central Hospital of Xinjiang,Karamay 834000,China;Department of Respiratory and Critical Care Medicine,Peking University People's Hospital,Beijing 100000,China)
出处
《中国全科医学》
CAS
北大核心
2021年第23期2902-2906,共5页
Chinese General Practice
基金
国家自然科学基金资助项目(81360016)
新疆自然科学基金资助项目(2020D01B06)
克拉玛依市人才创新项目(2019RC001A-11)。
关键词
睡眠呼吸暂停综合征
高血压
糖尿病
汉族
维吾尔族
随访研究
Sleep apnea syndromes
Hypertension
Diabetes mellitus
Han nationality
Uygur nationality
Follow-up studies
