Bao Xuping, Nelesen Richard A, Loredo Jose S, Dimsdale Joel E, Ziegler Michael G
Department of Medicine, University of California San Diego, 92103-8341, USA.
Blood Press Monit. 2002 Dec;7(6):301-7. doi: 10.1097/00126097-200212000-00002.
Many studies support a link between obstructive sleep apnea (OSA), increased blood pressure (BP) and/or BP variability, and sympathetic nervous system (SNS) activity. We assessed the relationship between SNS activity and 24-h BP variability in patients with OSA, and the effect of continuous positive airway pressure (CPAP) on BP variability.
Forty-one patients with a respiratory disturbance index (RDI) > 15 were randomized into CPAP or CPAP placebo groups for a 1-week trial.
Ambulatory BP, 24-h urine norepinephrine (NE) and polysomnography were measured prior to treatment and after 1 and 7 days of treatment.
Neither RDI nor 24-h urine NE levels were related to 24-h mean BP levels. While RDI was associated only with night-time BP variability, daytime urine NE levels were associated with both night-time and daytime BP variability. After treatment, the BP variability decreased significantly but equally in both active and placebo CPAP groups.
Obstructive sleep apnea is more related to BP variability than BP. Sympathetic nervous activity, as inferred from daytime urine NE, is related to changes in BP variability in OSA patients. BP variability is not specifically affected by CPAP.
许多研究支持阻塞性睡眠呼吸暂停（OSA）、血压（BP）升高和/或血压变异性与交感神经系统（SNS）活动之间存在联系。我们评估了OSA患者SNS活动与24小时血压变异性之间的关系，以及持续气道正压通气（CPAP）对血压变异性的影响。
41例呼吸紊乱指数（RDI）>15的患者被随机分为CPAP组或CPAP安慰剂组，进行为期1周的试验。
在治疗前以及治疗1天和7天后测量动态血压、24小时尿去甲肾上腺素（NE）和多导睡眠图。
RDI和24小时尿NE水平均与24小时平均血压水平无关。虽然RDI仅与夜间血压变异性相关，但白天尿NE水平与夜间和白天血压变异性均相关。治疗后，活性CPAP组和安慰剂CPAP组的血压变异性均显著降低，但降低程度相同。
阻塞性睡眠呼吸暂停与血压变异性的关系比与血压的关系更为密切。从白天尿NE推断，交感神经活动与OSA患者血压变异性的变化有关。CPAP对血压变异性没有特异性影响。
