睡眠呼吸暂停相关心动减缓与晨起血压的关联性研究(英文）

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1、SleepApneaassociated-BradycardiaandtheMorningBloodPressureXuQingRespiratoryDept.WuhanUnionHospitalBackgroundobstructivesleepapnea-hypopneasyndromeOSAHSApneaIntermittentHypoxemiaArousalSystemicHypertentionApneaassociated-Bradycardia&CorrespondingBPFluctuationsOSAHSApneaasso

2、ciated-BradycardiaTime(s)Heartrate(bpm)Apre-eventperiodBhypopneaCpost-eventrecoveryperiodHRBarbaraJ.Morgan,SLEEP,1998,21:737-746.？HT△HRVagalnerveSympatheticnerve？BPelevated？△BPObjectiveToexploretherelevanceofSAassociated-bradycardiatothemorningbloodpressureToinvestigatethe

3、roleofvagalnervoussystemplaysinOSAHSassociatedhypertensionSubjectsN＝104OSAHSpatientM:F＝94:10SymptomsPE：BPLabtestpolysomnography,PSGMethodsPSGrespiratoryinductiveplethysmography，RIPDareaRespitrace,AmbulatoryMonitoring,SensorMedicsco.AmericaParametersinvolvedAgeBodyMassIndex

4、,BMIApnea-HypopneaIndex,AHINocturnalMinimumofArterialOxygenSaturation,nSaO2％minPercentageofDwellTimeofArterialOxygenSaturationlowerthan90%，DT90%DeviationofHeartRate,DHRBloodPressureMAP=DBP+1/3(SBP-DBP)ResultsThemorningBPvs.Pre-sleepBPTable1.ComparisonofthemorningBPtoPre-sl

5、eepBPin104OSAHSpatientsx±s，(median)ParameterPre-sleepMorningMorning-prestatisticPvalueSBP(mmHg)†123.54±17.76(120)128.30±17.89(125)4.79±10.87(4)-4.1720.000*DBP(mmHg)†81.96±9.61(80)88.58±10.64(88)6.62±7.37(8)-6.9180.000*MAP(mmHg)‡95.82±11.50(93.33)101.83±12.32(100)6.01±7.76

6、(5.33)-7.8940.000**P<0.01，†WilcoxonRanksumtest，‡Pairedt–test***ComparisonbetweenthemorningBPandthePre-sleepBPFigure1.ThemorningBP(median)iselevatedcomparedtothepre-sleepBP(*P<0.01)020406080100120140Pre-sleepMorningBP(mmHg)SBPDBPMAPConstructionofhypertensionRelevanceofDHRt

7、othemorningBPTable2.CorrelationtestofSAassociatedDHRandBPpre-/post-sleepSBPbs‡(mmHg)DBPbs‡(mmHg)SBPas‡(mmHg)DBPas‡(mmHg)MAPbs†(mmHg)MAPas†(mmHg)DHR(bpm)r0.0850.1630.1210.214*0.1410.149P0.3920.0970.2230.0290.1520.130*P<0.05，†simplecorrelationanalysis；‡rankcorrelationanalysi

8、s.RelevanceofDHRtothemorningDBPDBP:diastolicbloodpressureMorningDBPFigure2.DHRispositivec