高血压伴阻塞性睡眠呼吸暂停低通气综合征患者发生左室肥厚的危险因素分析
Risk factor analysis of left ventricular hypertrophy in patients with hypertension and obstructive sleep apnea-hypopnea syndrome

目的:探讨高血压伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生左室肥厚的危险因素。方法:选取高血压伴OSAHS患者347例,根据左室质量指数(LVMI,g/m2)≥115(男)或≥95(女)将患者分为左室肥厚组(n=45)和对照组(n=302)。比较两组患者一般临床资料、睡眠呼吸暂停低通气指数(AHI)、血压变异性等指标,采用logistic回归分析高血压伴OSAHS患者发生左室肥厚的影响因素。结果:高血压伴OSAHS人群中,左室肥厚组女性患者比例、AHI、24 h收缩压变异性均高于对照组(P均<0.05)。将以上因素纳入logistic回归,结果显示:性别、AHI、24 h收缩压变异性为LVMI的影响因素,OR(95%CI)分别为0.323(0.136～0.770)、1.036(1.019～1.052)、1.228(1.117～1.350)。结论:高血压伴OSAHS患者中,女性、高AHI及24 h收缩压变异性为左室肥厚的危险因素。
Aim: To explore the risk factors of left ventricle hypertrophy in patients with hypertension and obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods: A total of 347 patients with hypertension and OSAHS were enrolled,and divided into two groups according to LVMI(g/m2)≥115(male)or ≥95(female), left ventricular hypertrophy group(n=45)and control group(n=302). General clinical data, AHI, blood pressure variability, etc were compared. The risk factors of left ventricular hypertrophy were analyzed by logistic regression.Results: The percentage of female patients, AHI and 24 h systolic pressure variability in left ventricular hypertrophy group were higher than those in control group(P<0.05). Logistic regression analysis of the above factors showed that gender,AHI,and 24 h systolic pressure variability were influencing factors of left ventricular hypertrophy, and OR(95%CI) were 0.323(0.136-0.770),1.036(1.019-1.052),1.228(1.117-1.350).Conclusion: Female,high AHI and 24 h systolic pressure variability are risk factors for the left ventricular hypertrophy in patients with hypertension and OSAHS