动态血压监测和褪黑激素昼夜节律合成对预测 1-2 级动脉高血压患者阻塞性睡眠呼吸暂停综合征的临床意义

V. Shyshko, I. A. Zubel, G. V. Malevich, V. V. Klysheiko, A. A. Targonskaya
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引用次数: 0

摘要

目的研究 24 小时动态血压监测(ABPM)和昼夜褪黑激素(MT)合成在预测 1-2 级动脉高血压(AH)患者阻塞性睡眠呼吸暂停综合征(OSAS)中的作用,并揭示研究结果之间的关系。材料和方法研究对象为 67 名 1-2 级动脉高血压患者,年龄为 50.0 (41.0; 56.0) 岁,根据临床和仪器研究方法的复杂程度分为两组:第 1 组 - 25 名 AH 患者,第 2 组 - 45 名 AH 伴有 OSAS 患者。进行了 24 小时 ABPM、人体测量和呼吸监测。通过尿液中 MT 代谢物 6-磺酸基褪黑素(6-COMT)的含量来评估 MT 水平。结果 研究发现,根据 ABPM,舒张压在一天中的变化幅度≥12 毫米汞柱,对于预测接受标准降压治疗的高血压患者的 OSAS 具有很高的灵敏度(74.1%)和特异性(91.7%)。高血压合并 OSAS 患者每日 MT 生成量的特征是每日尿液中 6-SOMT 水平(p=0.031)及其每日部分(p=0.037)的增加,这与 OSAS 的严重程度相关(分别为 r=0.43;p=0.00065 和 r=0.40;p=0.00079),且与高血压的等级无关(p>0.05)。结论根据所获得的结果,我们建议使用 ABPM 作为筛查手段,以低成本预测 1-2 级 AH 患者的 OSAS。已确定的 MT 合成每日节律的变化与 OSAS 的严重程度和高血压程度关系不大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CLINICAL SIGNIFICANCE OF AMBULATORY BLOOD PRESSURE MONITORING AND CIRCADIAN SYNTHESIS OF MELATONIN IN PREDICTING OBSTRUCTIVE SLEEP APNEA SYNDROME IN PATIENTS WITH GRADE 1-2 ARTERIAL HYPERTENSION
Objective. To study the role of 24-hour ambulatory blood pressure monitoring (ABPM) and circadian melatonin (MT) synthesis in predicting obstructive sleep apnea syndrome (OSAS) in patients with grade 1-2 arterial hypertension (AH) and to reveal the relationship between the study findings. Material and methods. 67 patients aged 50.0 (41.0; 56.0) having grade 1-2 AH were examined and divided into 2 groups in regard to the complex of clinical and instrumental research methods: Group 1 – 25 patients having AH and Group – 45 patients having AH associated with OSAS. 24-hour ABPM, anthropometric measurements, and respiratory monitoring were performed. MT levels were evaluated by the content of its metabolite 6-sulfatoxymelatonin (6-COMT) in the urine. Results It has been found that according to ABPM diastolic blood pressure variability during the day was ≥12 mm Hg and had high sensitivity (74.1%) and specificity (91.7%) for predicting the OSAS in patients with hypertension receiving standard antihypertensive therapy. The characteristic feature of the daily MT production in patients with AH in combination with OSAS is an increase in the level of 6-SOMT in daily urine (p=0.031) and its daily portion (p=0.037), correlating with the severity of OSAS (r=0.43; p=0.00065 and r=0.40; p=0.00079, respectively) and independent of the grade of AH (p>0.05). Conclusion. The obtained results allow us to recommend the use of ABPM as a screening, low-cost study to predict OSAS in patients with grade 1-2 AH. The identified changes in the daily rhythm of MT synthesis weakly correlate with the severity of OSAS and the degree of hypertension.
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