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Eur Respir J:24h动态血压监测对接受CPAP治疗的OSA患者有何价值?

2017-10-20 xing.T MedSci原创

该研究的结果表明,夜间高血压、血压昼夜模式和夜间心率可能是CPAP治疗血压反应的预测因子,这些结果支持对OSA患者在CPAP治疗开始前进行24小时动态血压监测。

连续气道正压通气(CPAP)降低血压的效果中等并且是高度可变的。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究析文章,在这项研究中,研究人员旨在确定对CPAP治疗有血压反应的预测变量。

研究人员对阻塞性睡眠呼吸暂停(OSA)在接受CPAP治疗6个月前后测量了患者24小时动态血压监测(ABPM)、C-反应蛋白(CRP)、瘦素、脂联素和24小时尿儿茶酚胺含量。

该研究共纳入了88名患者重度OSA(平均呼吸暂停低通气指数为42次每小时)的肥胖男性;28.4%的患者有高血压。62例患者完成了研究,研究人员对60例患者进行分析。CPAP治疗后白天舒张压(-2mmHg)和去甲肾上腺素(-109.5nmol/天)均有所降低,但24小时血压、夜间血压、多巴胺、肾上腺素、CRP、血清瘦素和脂联素水平没有明显变化。接受CPAP治疗后,夜间血压正常与和夜间血压升高相关(+4mmHg),而夜间高血压与降低的24小时血压相关(-3mmHg)。多元线性回归模型显示CPAP治疗后夜间血压差异显著。具体来说,夜间心率低(<68bpm)以及勺型血压与升高的夜间BP和新诊断的夜间高血压相关。

该研究的结果表明,夜间高血压、血压昼夜模式和夜间心率可能是CPAP治疗血压反应的预测因子,这些结果支持对OSA患者在CPAP治疗开始前进行24小时动态血压监测。

原始出处:

Anabel L. Castro-Grattoni,et al. Blood pressure response to CPAP treatment in subjects with obstructive sleep apnoea: the predictive value of 24-h ambulatory blood pressure monitoring. Eur Respir J.2017. http://erj.ersjournals.com/content/50/4/1700651

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    2017-10-22 bioon3
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  6. [GetPortalCommentsPageByObjectIdResponse(id=2022162, encodeId=d1402022162e0, content=<a href='/topic/show?id=348a3311836' target=_blank style='color:#2F92EE;'>#动态血压监#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33118, encryptionId=348a3311836, topicName=动态血压监)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=85df2500173, createdName=654699882_84926986, createdTime=Wed Feb 14 04:55:00 CST 2018, time=2018-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030156, encodeId=509f203015622, content=<a href='/topic/show?id=d88913e2636' target=_blank style='color:#2F92EE;'>#PAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13726, encryptionId=d88913e2636, topicName=PAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Thu Jul 05 07:55:00 CST 2018, time=2018-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331363, encodeId=c492133136379, content=<a href='/topic/show?id=1b32515586' target=_blank style='color:#2F92EE;'>#CPAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5155, encryptionId=1b32515586, topicName=CPAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0802500050, createdName=肉我只吃一口, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349759, encodeId=9e3c1349e598b, content=<a href='/topic/show?id=3d0d134904c' target=_blank style='color:#2F92EE;'>#OSA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13490, encryptionId=3d0d134904c, topicName=OSA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458363, encodeId=6b8a145836324, content=<a href='/topic/show?id=e7543311913' target=_blank style='color:#2F92EE;'>#动态血压监测#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33119, encryptionId=e7543311913, topicName=动态血压监测)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d7096025384, createdName=lsndxfj, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508994, encodeId=825a150899496, content=<a href='/topic/show?id=a7c83311e88' target=_blank style='color:#2F92EE;'>#动态血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33117, encryptionId=a7c83311e88, topicName=动态血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c1e10025437, createdName=limedical1977, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254686, encodeId=8f1125468603, content=连续气道正压通气(CPAP)降低血压的效果中等并且是高度可变的, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Oct 20 23:24:57 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254601, encodeId=935d2546016a, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Oct 20 13:49:20 CST 2017, time=2017-10-20, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2022162, encodeId=d1402022162e0, content=<a href='/topic/show?id=348a3311836' target=_blank style='color:#2F92EE;'>#动态血压监#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33118, encryptionId=348a3311836, topicName=动态血压监)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=85df2500173, createdName=654699882_84926986, createdTime=Wed Feb 14 04:55:00 CST 2018, time=2018-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030156, encodeId=509f203015622, content=<a href='/topic/show?id=d88913e2636' target=_blank style='color:#2F92EE;'>#PAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13726, encryptionId=d88913e2636, topicName=PAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Thu Jul 05 07:55:00 CST 2018, time=2018-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331363, encodeId=c492133136379, content=<a href='/topic/show?id=1b32515586' target=_blank style='color:#2F92EE;'>#CPAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5155, encryptionId=1b32515586, topicName=CPAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0802500050, createdName=肉我只吃一口, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1349759, encodeId=9e3c1349e598b, content=<a href='/topic/show?id=3d0d134904c' target=_blank style='color:#2F92EE;'>#OSA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13490, encryptionId=3d0d134904c, topicName=OSA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=322359, createdName=bioon3, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1458363, encodeId=6b8a145836324, content=<a href='/topic/show?id=e7543311913' target=_blank style='color:#2F92EE;'>#动态血压监测#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33119, encryptionId=e7543311913, topicName=动态血压监测)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d7096025384, createdName=lsndxfj, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508994, encodeId=825a150899496, content=<a href='/topic/show?id=a7c83311e88' target=_blank style='color:#2F92EE;'>#动态血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33117, encryptionId=a7c83311e88, topicName=动态血压)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c1e10025437, createdName=limedical1977, createdTime=Sun Oct 22 03:55:00 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254686, encodeId=8f1125468603, content=连续气道正压通气(CPAP)降低血压的效果中等并且是高度可变的, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Fri Oct 20 23:24:57 CST 2017, time=2017-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254601, encodeId=935d2546016a, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=143, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Oct 20 13:49:20 CST 2017, time=2017-10-20, status=1, ipAttribution=)]
    2017-10-20 有备才能无患

    连续气道正压通气(CPAP)降低血压的效果中等并且是高度可变的

    0

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    2017-10-20 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

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