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)_第1页
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)_第2页
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)_第3页
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)_第4页
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)_第5页
已阅读5页,还剩14页未读 继续免费阅读

下载本文档

版权说明:本文档由用户提供并上传,收益归属内容提供方,若内容存在侵权,请进行举报或认领

文档简介

Sleep Apnea associated- Bradycardia and the Morning Blood Pressure Xu Qing Respiratory Dept. Wuhan Union Hospital Background obstructive sleep apnea-hypopnea syndrome OSAHS Apnea Intermittent Hypoxemia Arousal Systemic Hypertention Apnea associated-Bradycardia & Corresponding BP Fluctuations OSAHS Apnea associated-Bradycardia Time(s) Heart rate(bpm ) A pre-event period B hypopnea C post-event recovery period HR Barbara J. Morgan, SLEEP, 1998, 21:737-746. ? HT HR Vagal nerve Sympathetic nerve ? BP elevated ? BP Objective JTo explore the relevance of SA associated-bradycardia to the morning blood pressure J To investigate the role of vagal nervous system plays in OSAHS associated hypertension Subjects J N 104 OSAHS patient J M:F 94:10 J Symptoms J PE: BP J Lab test polysomnography, PSG Methods PSG respiratory inductive plethysmography, RIP D area Respitrace, Ambulatory Monitoring, SensorMedics co. America Parameters involved J Age J Body Mass Index, BMI J Apnea-Hypopnea Index, AHI J Nocturnal Minimum of Arterial Oxygen Saturation, nSaO2 min J Percentage of Dwell Time of Arterial Oxygen Saturation lower than 90%, DT90% J Deviation of Heart Rate, DHR J Blood Pressure MAP=DBP+1/3(SBP-DBP) Results The morning BP vs. Pre-sleep BP Table 1. Comparison of the morning BP to Pre-sleep BP in 104 OSAHS patients x s, (median) Parameter Pre-sleep Morning Morning - pre statistic P value SBP (mm Hg) 123.54 17.76 (120) 128.30 17.89 (125) 4.7910.87 (4) - 4.172 0.000* DBP (mm Hg) 81.96 9.61 (80) 88.58 10.64 (88) 6.62 7.37 (8) - 6.918 0.000* MAP (mm Hg) 95.82 11.50 (93.33) 101.83 12.32 (100) 6.01 7.76 (5.33) - 7.894 0.000* * P 0.01, Wilcoxon Rank sum test, Paired t test * * Comparison between the morning BP and the Pre-sleep BP Figure1. The morning BP (median) is elevated compared to the pre-sleep BP (* P0.01) 0 20 40 60 80 100 120 140 Pre-sleep Morning BP(mm Hg) SBP DBP MAP Construction of hypertension Relevance of DHR to the morning BP Table 2. Correlation test of SA associated DHR and BP pre-/post-sleep SBPbs (mm Hg) DBPbs (mm Hg) SBPas (mm Hg) DBPas (mm Hg) MAPbs (mm Hg) MAPas (mm Hg) DHR (bpm) r 0.085 0.163 0.121 0.214 * 0.141 0.149 P 0.392 0.097 0.223 0.029 0.152 0.130 * P 0.05, simple correlation analysis; rank correlation analysis. Relevance of DHR to the morning DBP DBP: diastolic blood pressure Morning DBP Figure 2. DHR is positive correlated with the morning diastolic blood pressure (r =0.214,P0.05). DHR (bpm) Relevance of DHR to the morning HT Table 3. Risk factors of hypertension by Logistic analysis in OSAHS patients Dependent variable Risk factor OR 95% CI c 2 P SHTas BMI 1.056 1.007 1.109 4.95 0.026 DHR 1.253 1.057 1.486 6.737 0.009 Age 1.126 1.037 1.222 7.964 0.005 DHTas BMI 1.244 1.076 1.439 8.708 0.003* * P 0.01, P 0.05, SHTas: Systolic hypertension after sleep, the Morning SBP 140 mmHg, DHTas: diastolic hypertension after sleep , the Morning DBP90 mmHg ,Age、 BMI、 AHI、 nSaO2%min 、 DT90% and DHR as independent variable. Summary J The morning DBP is elevated remarkably in OSAHS patients compared with the SBP J SA associated-bradycardia is correlated with the morning diastolic blood pressure J The amplitude of bradyc

温馨提示

  • 1. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
  • 2. 本站的文档不包含任何第三方提供的附件图纸等,如果需要附件,请联系上传者。文件的所有权益归上传用户所有。
  • 3. 本站RAR压缩包中若带图纸,网页内容里面会有图纸预览,若没有图纸预览就没有图纸。
  • 4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
  • 5. 人人文库网仅提供信息存储空间,仅对用户上传内容的表现方式做保护处理,对用户上传分享的文档内容本身不做任何修改或编辑,并不能对任何下载内容负责。
  • 6. 下载文件中如有侵权或不适当内容,请与我们联系,我们立即纠正。
  • 7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。

评论

0/150

提交评论