文章摘要
江洁,陈洁霞,奚艳,等.高血压合并中重度阻塞性睡眠呼吸暂停低通气综合征患者动态血压特征及反勺型血压的影响因素[J].中国临床保健杂志,2026,29(3):368-372.
高血压合并中重度阻塞性睡眠呼吸暂停低通气综合征患者动态血压特征及反勺型血压的影响因素
Ambulatory blood pressure characteristics and factors influencing non-dipping blood pressure patterns in hypertensive patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome
投稿时间：2026-01-22  
DOI：10.3969/J.issn.1672-6790.2026.03.014
中文关键词: 高血压  睡眠呼吸暂停,阻塞性  血压  昼夜节律  危险因素
英文关键词: Hypertension  Sleep apnea,obstructive  Blood pressure  Circadian rhythm  Risk factors Fund program:Anhui Provincial Health Research Project
基金项目:安徽省卫生健康科研项目
作者单位E-mail
江洁 安徽医科大学第一附属医院全科医学科,合肥 230022 chenjiexia25@fy.ahmu.edu.cn 
陈洁霞 安徽医科大学第一附属医院全科医学科,合肥 230022 chenjiexia25@fy.ahmu.edu.cn 
奚艳 安徽医科大学第一附属医院全科医学科,合肥 230022 chenjiexia25@fy.ahmu.edu.cn 
黄荣彩 安徽医科大学第一附属医院全科医学科,合肥 230022 chenjiexia25@fy.ahmu.edu.cn 
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中文摘要:
      目的 探讨高血压合并中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的动态血压特征,并分析其发生反勺型血压的独立危险因素。方法 回顾性选取2019年10月至2025年6月在安徽医科大学第一附属医院住院的87例高血压患者的临床资料。根据睡眠呼吸暂停低通气指数(AHI)将患者分为对照组(单纯高血压或合并轻度OSAHS,27例)与观察组(高血压合并中重度OSAHS,60例)。获取患者的一般资料、睡眠监测及24 h动态血压监测数据。采用多因素logistic回归模型分析发生反勺型血压的独立影响因素。结果 观察组体重指数(BMI)水平明显高于对照组(P＜0.05)；观察组睡眠呼吸暂停低通气指数(AHI)、氧减指数(ODI)、血氧饱和度低于90%的时间(ST90)均显著高于对照组,而平均血氧饱和度(MeanSpO2)、最低血氧饱和度(LSpO2)显著低于对照组(P＜0.01)。两组间24 h平均收缩压(24 hSBP)、24 h平均舒张压(24 hDBP)及日间平均收缩压(dSBP)比较,差异均无统计学意义(均P＞0.05)。观察组夜间平均收缩压(nSBP)显著高于对照组(P＜0.05)。观察组夜间收缩压及舒张压下降百分比较对照组均显著降低(P＜0.01),且反勺型血压占比显著高于对照组(P＜0.01)。多因素logistic回归分析显示,年龄和AHI是发生反勺型血压的独立危险因素(P＜0.01)。结论 中重度OSAHS患者伴有严重的夜间缺氧及压力负荷,其夜间收缩压水平显著升高,且反勺型血压比例更高。年龄增长与AHI水平升高是高血压合并OSAHS患者出现反勺型血压的独立危险因素。
英文摘要:
      Objective To explore the ambulatory blood pressure monitoring (ABPM) characteristics in hypertensive patients with moderate-to-severe obstructive sleep apnea-hypopnea syndrome (OSAHS),and to identify the independent risk factors for the occurrence of a non-dipping blood pressure pattern.Methods A total of 87 hypertensive patients hospitalized at the First Affiliated Hospital of Anhui Medical University from October 2019 to June 2025 were enrolled.Participants were divided into a control group (isolated hypertension or hypertension with mild OSAHS,n=27) and an observation group (hypertension with moderate-to-severe OSAHS,n=60) based on OSAHS severity.General clinical data,sleep breathing monitoringparameters,and 24-hour ABPM indices were compared between the two groups.Multivariable logistic regression analysis was performed to identify independent risk factors for the riser (reversed-dipper) blood pressure pattern in patients with OSAHS.Results The body mass index (BMI) was significantly higher in the observation group compared to the control group (P<0.05).In terms of respiratory parameters,the apnea-hypopnea index (AHI),oxygen desaturation index (ODI),and time spent with SpO2 below 90% (ST90) were significantly higher,while mean pulse oxygen saturation (MeanSpO2) and lowest pulse oxygen saturation (LSpO2) were significantly lower in the observation group (P<0.01).No significant differences were observed between the two groups in 24-hour mean systolic blood pressure (24 hSBP),24-hour mean diastolic blood pressure (24 hDBP),or daytime systolic blood pressure (dSBP) (P>0.05).However,nighttime systolic blood pressure (nSBP) was significantly higher in the observation group (P<0.05).Furthermore,the percentages of nocturnal SBP and DBP dipping were significantly lower in the observation group (P<0.01),which also exhibited a significantly higher prevalence of the riser blood pressure pattern (P<0.01).Multivariable logistic regression analysis identified age and AHI as independent risk factors for the development of a riser blood pressure pattern (P<0.01).Conclusions Patients with moderate-to-severe OSAHS exhibit severe nocturnal hypoxia and pressure load,leading to significantly elevated nocturnal SBP and a higher prevalence of the reverse-dipper blood pressure pattern.Increased age and higher AHI levels are independent risk factors for reverse-dipper patterns in hypertensive patients with OSAHS.
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