文献类型：期刊文献

中文题名：老年女性高血压与阻塞性呼吸睡眠暂停综合征的相关性及其对脑卒中的影响

英文题名：Relationship between hypertension and OSAHS and the effect of hypertension and OSAHS on stroke in elderly females

作者：孔晓晅[1];林俊岭[3];郭静静[4];陈开兵[5];高燕[6];李建华[1];苏小凤[7];赵力博[1];范利[1];刘霖[2]

第一作者：孔晓晅

机构：[1]解放军总医院第二医学中心心血管内科国家老年疾病临床医学研究中心,北京100853;[2]解放军总医院第二医学中心心呼吸与危重症医学科,北京100853;[3]首都医科大学附属北京朝阳医院呼吸与危重症医学科;[4]北京大学人民医院呼吸科;[5]甘肃中医药大学附属医院睡眠医学科;[6]解放军第九六〇医院全科医学科;[7]延安大学医学院

第一机构：解放军总医院第二医学中心心血管内科国家老年疾病临床医学研究中心,北京100853

年份：2022

卷号：24

期号：6

起止页码：599

中文期刊名：中华老年心脑血管病杂志

外文期刊名：Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

收录：CSTPCD;;北大核心:【北大核心2020】；

基金：国家老年疾病临床医学研究中心开放课题(NCRCG-PLAGH-2018008);解放军总医院军事医学青年项目(QNC19054);军队保健专项科研课题(19BJZ34);解放军总医院第二医学中心专项科研课题(ZXD2008)。

语种：中文

中文关键词：高血压;睡眠呼吸暂停,阻塞性;卒中;睡眠;血氧测定法;女性

外文关键词：hypertension;sleep apnea,obstructive;stroke;sleep;oximetry;femininity

摘要：目的分析老年女性高血压与阻塞性呼吸睡眠暂停低通气综合征(OSAHS)的相关性,并探讨二者对脑卒中的影响。方法纳入多中心老年女性OSAHS患者492例,其中合并高血压329例(66.9%),根据呼吸暂停-低呼吸指数(AHI)分为轻度组138例,中度组192例和重度组162例,收集各组睡眠参数、随访脑卒中的发生情况。采用Pearson相关分析对睡眠参数与高血压分级的关系,采用二元logistics回归筛选脑卒中结局的影响因素。结果3组AHI、氧饱和度指数(ODI)、最低脉搏血氧饱和度(LSpO_(2))、总睡眠时间比较,差异有统计学意义(P<0.05,P<0.01)。高血压患者ODI明显高于非高血压患者,平均脉搏血氧饱和度(MSpO_(2))、LSpO_(2)明显低于非高血压患者(P<0.05)。Pearson相关性分析显示,AHI、ODI、总睡眠时间和呼吸暂停平均时间与高血压呈正相关(P<0.05,P<0.01),MSpO_(2)和LSpO_(2)与高血压呈负相关(P<0.01)。重度组脑卒中发生率明显高于轻、中度组(21.6%vs 12.3%,12.5%,P<0.05)。高血压患者脑卒中发生率明显高于非高血压患者(20.4%vs 5.5%,P=0.000)。二元logistic回归分析显示,呼吸暂停平均时间是脑卒中的危险因素(OR=1.040,95%CI:1.009~1.072,P<0.05)。结论老年女性OSAHS患者的高血压发病率较高,高血压分级与ODI和LSpO_(2)相关,高血压患者较非高血压患者发生脑卒中的可能性更大。呼吸暂停平均时间是脑卒中的独立危险因素。
Objective To analyze the relationship between hypertension and OSAHS and the effect of hypertension and OSAHS on stroke in elderly females.Methods Four hundred and ninety-two elderly female OSAHS patients were divided into mild OSAHS group(n=138),moderate OSAHS group(n=192)and severe OSAHS group(n=162).The sleep parameters in 3 groups were recorded.The patients were followed up,during which the incidence of stroke was recorded.The relationship between sleep parameters and hypertension grading was analyzed by Pearson correlation analysis.The risk factors for the otcome of stroke were analyzed by binay logistic regression analysis.Results The AHI,ODI,LSpO_(2),and total sleep time were significantly different in 3 groups(P<0.01).The ODI was siginificantly higher while the MSpO_(2) and LSpO_(2) were significantly lower in hypertendion patients than in hypertendion-free patients(P<0.05).Pearson correlation analysisshowed that AHI,ODI,total sleep time and mean apnea time were positively related with hypertemssion while MSpO_(2) and LSpO_(2) were negatively related with hypertesion (P <0.01).The incidence of stroke was significantly higher in severe OSAHS group than in mild OSAHS group and moderate OSAHS group(21.6% vs 12.3%,21.6% vs 12.5%,P <0.05)and in hypertension patients than in hypertension-free patients(20.4% vs 5.5%,P =0.000).Binary logistic regression analysis revealed that mean apnea time was a risk factor for stroke in elderly female OSAHS patients(OR =1.040,95%CI:1.009-1.072,P <0.05).Conclusion The inci-dence of hypertensionis high,hypertension grading is related with ODI and LSpO_(2),and mean ap-nea time is an independent risk factor for strke in elderly female OSAHS patients.