Hypertension:阻塞性睡眠呼吸暂停特征与夜间血压波动的关系

2018-10-02 xing.T MedSci原创

由此可见,该临床研究采用非侵入性示波法测量确定了快速眼动睡眠和严重氧饱和度下降对OSA相关血压升高的影响。

研究表明,阻塞性睡眠呼吸暂停(OSA)期间的氧饱和度降低和睡眠阶段与高血压(BP)的程度有关。然而,在临床研究中,这些关联尚未得到很好地证实。近日,血管权威杂志Hypertension上发表了一篇研究文章,研究人员使用无创示波BP测量设备来调查每次OSA事件结束时氧气触发的血压水平与之前OSA事件特征之间的关联。

在42例新诊断的OSA患者中(平均年龄为63.5±12.5岁;平均呼吸暂停-低通气指数为每小时32.6±18.2),在OSA发作结束时获得258次血压测量值。缺氧-峰值收缩压(SBP),定义为最大氧气触发的SBP值,在快速眼动睡眠(144.9±19.9 mmHg)中显著高于非快速眼动1期睡眠(129.5±15.1 mmHg; P<0.001)和非快速眼动2期睡眠(129.4±14.7 mmHg; P<0.001)。

在多变量线性混合模型中,每次OSA发作期间的最低氧饱和度百分比与缺氧-峰值SBP增加(-0.501mmHg; P<0.001)、夜间SBP激增(其定义为缺氧-峰值SBP和平均夜间SBP之间的差值,-0.395 mmHg; P<0.001)以及SBP激增的最大值(定义为缺氧-峰值SBP和最小夜间SBP之间的差值,-0.468 mmHg; P<0.001)相关。这些值与每次OSA事件的持续时间无关。

由此可见,该临床研究采用非侵入性示波法测量确定了快速眼动睡眠和严重氧饱和度下降对OSA相关血压升高的影响。

原始出处:


Nobuo Sasaki,et al. Associations Between Characteristics of Obstructive Sleep Apnea and Nocturnal Blood Pressure Surge.Hypertension.2018. https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.11794

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    2020-12-31 ms1000002016287811

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    2019-06-10 柳叶一刀
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encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Thu Jan 31 14:47:00 CST 2019, time=2019-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501327, encodeId=4615150132ea7, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Thu Oct 04 02:47:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589041, encodeId=61a21589041d8, content=<a href='/topic/show?id=2b504354483' target=_blank style='color:#2F92EE;'>#夜间血压#</a>, beContent=null, 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encodeId=c75534e8111c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Wed Oct 03 21:54:54 CST 2018, time=2018-10-03, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=912510, encodeId=155091251081, content=学习,加积分😊, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc115448783, createdName=ms1000002016287811, createdTime=Thu Dec 31 11:11:00 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1727651, encodeId=db2d1e2765187, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Jun 10 15:47:00 CST 2019, time=2019-06-10, status=1, ipAttribution=), 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encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Thu Jan 31 14:47:00 CST 2019, time=2019-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501327, encodeId=4615150132ea7, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Thu Oct 04 02:47:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589041, encodeId=61a21589041d8, content=<a href='/topic/show?id=2b504354483' target=_blank style='color:#2F92EE;'>#夜间血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43544, encryptionId=2b504354483, topicName=夜间血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Thu Oct 04 02:47:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596546, encodeId=e3d2159654681, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Thu Oct 04 02:47:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347811, encodeId=c75534e8111c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Wed Oct 03 21:54:54 CST 2018, time=2018-10-03, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=912510, encodeId=155091251081, content=学习,加积分😊, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc115448783, createdName=ms1000002016287811, createdTime=Thu Dec 31 11:11:00 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1727651, encodeId=db2d1e2765187, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Jun 10 15:47:00 CST 2019, time=2019-06-10, status=1, ipAttribution=), 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createdBy=6ab940, createdName=hukaixun, createdTime=Tue Jul 09 11:47:00 CST 2019, time=2019-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1989102, encodeId=de9a1989102bd, content=<a href='/topic/show?id=246ee29858f' target=_blank style='color:#2F92EE;'>#睡眠呼吸#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72985, encryptionId=246ee29858f, topicName=睡眠呼吸)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3138208, createdName=zhanfl, createdTime=Sat Apr 20 23:47:00 CST 2019, time=2019-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696851, encodeId=0122169685105, content=<a href='/topic/show?id=d2e99e651e4' target=_blank style='color:#2F92EE;'>#阻塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97651, encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Thu Jan 31 14:47:00 CST 2019, time=2019-01-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1501327, encodeId=4615150132ea7, content=<a href='/topic/show?id=f2db9238f9' target=_blank style='color:#2F92EE;'>#Hypertension#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9238, encryptionId=f2db9238f9, topicName=Hypertension)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11ff9497046, createdName=jambiya, createdTime=Thu Oct 04 02:47:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589041, encodeId=61a21589041d8, content=<a href='/topic/show?id=2b504354483' target=_blank style='color:#2F92EE;'>#夜间血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43544, encryptionId=2b504354483, topicName=夜间血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Thu Oct 04 02:47:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596546, encodeId=e3d2159654681, content=<a href='/topic/show?id=70e4396491a' target=_blank style='color:#2F92EE;'>#呼吸暂停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39649, encryptionId=70e4396491a, topicName=呼吸暂停)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e2a518392360, createdName=119337463, createdTime=Thu Oct 04 02:47:00 CST 2018, time=2018-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347811, encodeId=c75534e8111c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Wed Oct 03 21:54:54 CST 2018, time=2018-10-03, status=1, ipAttribution=)]
    2019-01-31 tomyang96
  7. 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  8. 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    2018-10-03 医者仁心5538

    学习了

    0

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8月21日,在线发表于《Respirology》杂志上的一项研究显示,阻塞性睡眠呼吸暂停(OSA)的严重程度与胆固醇和甘油三酯水平独立相关。

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由此可见,该研究的个体患者荟萃分析显示OSA患者的动脉僵硬程度增加是由传统的心血管危险因素而非呼吸暂停参数所至。

Chest:运动训练和CPAP对心力衰竭和OSA患者的影响

由此可见,在HF和OSA患者中,该研究的初步结果显示单独的运动可以改善OSA,提高生活质量,但CPAP不能。在HF患者OSA的治疗中,该研究是唯一的一项显示任何治疗(运动)可改善所有研究参数的随机试验。该研究的结果突出了运动的重要治疗益处,特别是对于CPAP依从性较低的个体。

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JAHA:OSA对接受双重抗血小板治疗的ACS患者血小板功能特征的影响

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