[1]陈杰,陆晓培,张彦,等.多导睡眠图联合心理评估在难治性高血压中的临床应用[J].福建医药杂志,2023,45(03):12-14.
　CHEN Jie,LU Xiaopei,ZHANG Yan,et al.Clinical application of polysomnography combined with psychological assessment in refractoryhypertension[J].FUJIAN MEDICAL JOURNAL,2023,45(03):12-14.
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多导睡眠图联合心理评估在难治性高血压中的临床应用()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期数:
2023年03期
页码:
12-14
栏目:
临床研究
出版日期:
2023-06-15

文章信息/Info

Title:
Clinical application of polysomnography combined with psychological assessment in refractoryhypertension
文章编号:
1002-2600(2023)03-0012-03
作者:
陈杰; 陆晓培; 张彦; 欧阳煜; 罗生辉
福建医科大学附属福州市第一医院神经内科(福州 350009)
Author(s):
CHEN Jie;  LU Xiaopei;  ZHANG Yan;  OU Yangyu;  LUO Shenghui
Department of Neurology, the First Hospital of Fuzhou Affiliated to Fujian Medical University, Fuzhou, Fujian 350009, China
关键词:
多导睡眠图;  心理评估;  难治性高血压
Keywords:
polysomnography;  psychological assessment;  refractory hypertension
分类号:
R749.7+2; R544.1
文献标志码:
B
摘要:
目的 探讨多导睡眠图联合心理评估在难治性高血压中的临床应用价值。方法 选取2020年6月至2022年10月到本院心内科就诊的难治性高血压(RH)合并打鼾的患者,进行多导睡眠图(PSG)监测筛选出阻塞性睡眠呼吸暂停综合征(OSAS)51例。同意自费购买呼吸机进行持续气道正压通气(CPAP)治疗的患者24例为研究组,未行CPAP治疗的患者27例为对照组。所有病例进行24 h动态血压监测,通过Zung抑郁自评量表(SDS)、Zung焦虑自评量表(SAS)。3个月后两组患者复查24 h动态血压,比较两组血压变化和SDS、SAS评分变化。结果 1)治疗3个月后,与对照组比较,研究组24 h收缩压、舒张压、白天收缩压及舒张压、夜间收缩压及舒张压的血压值降低幅度更大(均P<0.05)。2)治疗3个月后,与对照组比较,研究组SAS评分降低幅度更大(P<0.05)。结论 伴OSAS的RH患者中,降压药物治疗基础上联合CPAP能够更好地控制24 h血压,经过CPAP治疗,伴OSAS的RH患者情绪变化能够得到进一步的改善。
Abstract:
Objective To explore the clinical application value of polysomnography combined with psychological assessment in refractory hypertension. Methods The study included the patients of refractory hypertension(RH)with snoring who were diagnosed at our hospital cardiology department during June 2020 to October 2022, by means of the examination with polysomnography(PSG). Fifty-one cases of obstructive sleep apnea syndrome(OSAS)were screened.Twenty-four patients who agreed to buy a ventilator for CPAP treatment at their own expense were included in the study group. Twenty-seven patients without CPAP treatment were included in the control group. All cases underwent 24-hour ambulatory blood pressure monitoring, and the psychological status was evaluated by Zung self-rating depression scale(SDS)and Zung self-rating anxiety scale(SAS).Three months later, the two groups were re-examined with 24-hour ambulatory blood pressure, and blood pressure changes, SDS and SAS scores were compared between the two groups. Results 1)After three months of treatment, the decrease of 24-hour systolic blood pressure, diastolic blood pressure, daytime systolic and diastolic blood pressure, nighttime systolic and diastolic blood pressure were greater in the study group than those in the control group(all P<0.05). 2)After three months of treatment, the decrease of SAS scores in the study group was greater than that in the control group(P<0.05). Conclusion In patients with refractory hypertension with OSAS, CPAP combined with antihypertensive medication can better control blood pressure in 24-hours, after the CPAP treatment, the patients' mood changes could be further improved.

参考文献/References:

[1] Egan B M, Zhao Y, Axon R N, et al. Uncontrolled and apparent treatment resistant hypertension in the United States, 1988 to 2008 [J]. Circulation, 2011, 124(9): 1046-1058.
[2] Tanner R M, Calhoun D A, Bell E K, et al. Prevalence of apparent treatment-resistant hypertension among individuals with CKD [J]. Clin J Am Soc Nephrol, 2013, 8(9): 1583-1590.
[3] Smith S M, Gong Y, Handberg E, et al. Predictors and outcomes of resistant hypertension among patients with coronary artery disease and hypertension [J]. J Hypertens, 2014, 32(3): 635-643.
[4] 李师承,刘伶,严晓伟.难治性高血压的诊疗进展[J].中国临床新医学, 2019, 12(5): 488-493.
[5] 《中国高血压防治指南》修订委员会.中国高血压防治指南2018年修订版[J].中国心血管杂志,2019,19(1):24-56.
[6] Yue W H, Liu P Z, Hao W,et al. The Study of Sleep Structure and Hypoxemia in 78 patients with Sleep Apnea Syndrome [J].Chinese Journal of Clinical Psychology, 2004,24(1):71-72.
[7] 董徽,蒋雄京.2018 AHA难治性高血压诊治管理科学声明评述[J].中国循环杂志,2018,33(11):35-38.
[8] 韩魁,张晨.难治性高血压诊治的研究进展[J].实用心脑肺血管病杂志,2019,27(12):233-236.
[9] 毛兴惠,江凤. 难治性高血压治疗研究进展 [J]. 现代医药卫生,2016,32(10):1508-1511.
[10] 孙宁玲,霍勇,王继光. 难治性高血压诊断治疗中国专家共识 [J].中华高血压杂志,2013,21(4): 321-325.
[11] Martinez-Garcia M A, Capote F, Campos-Rodriguez F, et al. Effect of CPAP on blood pressure in patients with obstructive sleep apnoea and resistant hypertension: the hiparco randomized clinical trial [J].JAMA, 2013, 310(22): 2407-2415.

备注/Memo

备注/Memo:
基金项目:福州市科技计划项目(2020-WS-128)
更新日期/Last Update: 2023-06-15