CPAP对OSAS合并顽固性高血压和糖尿病患者的降压效果及对糖代谢的影响

    Effect of CPAP on the glucose metabolism and antihypertension in OSAS patients with resistant hypertension complicated with diabetes

    • 摘要: 目的: 探讨持续气道无创正压通气(CPAP)对阻塞性睡眠呼吸暂停综合征(OSAS)合并顽固性高血压和糖尿病患者降压效果及对糖代谢的影响。方法: 将OSAS合并顽固性高血压和2型糖尿病患者89例随机分为2组,对照组42例以常规降压药物和降糖药物治疗;CPAP组47例在常规降压药物和降糖药物治疗基础上每晚加用CPAP治疗6 h。治疗3个月后,比较2组24 h血压各项血压指标和空腹血糖。结果: 治疗3个月后,CPAP组和对照组24 h平均收缩压、24 h平均舒张压、白天平均收缩压、白天平均舒张压、夜间平均收缩压和夜间平均舒张压均较治疗前显著降低(P<0.01),CPAP组各项血压指标降低幅度均明显高于对照组(P<0.01)。CPAP组治疗前空腹血糖≤7.0 mmol/L 10例(23.8%),治疗结束后空腹血糖≤7.0 mmol/L 35例(83.3%),对照组治疗前、后空腹血糖≤7.0 mmol/L均为5例(12.5%)。结论: CPAP联合药物治疗对OSAS合并顽固型高血压和糖尿病患者疗效好于单纯药物治疗。

       

      Abstract: Objective: To investigate the effects of non-invasive continuos positive airway pressure(CPAP) on the glucose metabolism and antihypertension in bbstructive sleep apnea syndrome(OSAS) patients with resistant hypertension complicated with diabetes.Methods: Eighty-nine OSAS patients with resistant hypertension complicated with type 2 diabetes were randomly divided into the CPAP group(n=47,treated with antihypertensive drugs,hypoglycemic agents combined with CPAP for 6 h every night) and control group(n=42,treated with antihypertensive drugs combined with hypoglycemic agents).The 24 h blood pressure and fasting blood glucose between two groups were compared after three month of treatment.Results: Compared with before treatment,the levels of 24hSBP,24hDBP,dSBP,dDBP,nSBP and nDBP in the two groups decreased significantly after three months of treatment(P<0.01).The decreasing degree of the blood pressure parameters in CPAP group was significantly higher than those in control group(P<0.01).The fasting blood glucose less than or equal to 7.0 mmol/L in 10 cases(23.8%) and 35 cases(23.8%) were found in CPAP group before and after treatment,respectively.The fasting blood glucose less than or equal to 7.0 mmol/L in 5 cases(12.5%) and 5 cases(12.5%) were found in control group before and after treatment,respectively.Conclusions: The treatment effects of CPAP combined with drugs on OSAS patients with resistant hypertension complicated with diabetes are better than the pure drug treatment.

       

    /

    返回文章
    返回