睡眠呼吸暂停相关心动减缓与晨起血压的关联性研究英文课件

1、Sleep Apnea associated- Bradycardia and the Morning Blood Pressure Xu QingRespiratory Dept. Wuhan Union HospitalBackgroundobstructive sleep apnea-hypopnea syndromeOSAHSApneaIntermittent HypoxemiaArousalSystemic HypertentionApnea associated-Bradycardia & Corresponding BP Fluctuations OSAHS Apnea asso

2、ciated-Bradycardia Time(s)Heart rate(bpm)A pre-event period B hypopnea C post-event recovery period HRBarbara J. Morgan, SLEEP, 1998, 21:737-746. ？HTHRVagal nerveSympathetic nerve ？BP elevated ？BPObjectiveTo explore the relevance of SA associated-bradycardia to the morning blood pressure To investig

3、ate the role of vagal nervous system plays in OSAHS associated hypertensionSubjects N104 OSAHS patient M:F 94:10 Symptoms PE： BP Lab test polysomnography, PSGMethodsResultsThe morning BP vs. Pre-sleep BPTable 1. Comparison of the morning BP to Pre-sleep BP in 104 OSAHS patients x s，(median) Paramete

4、rPre-sleepMorningMorning - prestatisticP value SBP (mm Hg) 123.54 17.76 (120)128.30 17.89 (125)4.7910.87(4)- 4.1720.000*DBP (mm Hg) 81.96 9.61 (80)88.58 10.64 (88)6.62 7.37(8)- 6.9180.000*MAP (mm Hg) 95.82 11.50 (93.33)101.83 12.32 (100)6.01 7.76(5.33)- 7.8940.000* * P 0.01， Wilcoxon Rank sum test，

5、Paired t test*Comparison betweenthe morning BP and the Pre-sleep BPFigure1. The morning BP (median) is elevatedcompared to the pre-sleep BP (* P0.01)020406080100120140Pre-sleep MorningBP(mm Hg)SBPDBPMAPRelevance of DHR to the morning HTTable 3. Risk factors of hypertension by Logistic analysis in OS

6、AHS patientsDependent variableRisk factorOR95% CIc 2P SHTasBMI1.0561.007 1.1094.950.026DHR1.2531.057 1.4866.7370.009Age1.1261.037 1.2227.9640.005DHTasBMI1.2441.076 1.4398.7080.003* P 0.01, P 0.05，SHTas: Systolic hypertension after sleep, the Morning SBP 140 mmHg, DHTas: diastolic hypertension after

7、sleep , the Morning DBP90 mmHg ,Age、BMI、AHI、nSaO2%min 、DT90% and DHR as independent variable.SummaryThe morning DBP is elevated remarkably in OSAHS patients compared with the SBPSA associated-bradycardia is correlated with the morning diastolic blood pressureThe amplitude of bradycardia during apnea (DHR) is an independent pre