2022 年第 7 期 第 17 卷

男性原发性高血压合并阻塞性睡眠呼吸暂停低通气综合征患者低氧血症与钠盐摄入量的相关性研究

Study on the correlation between hypoxemia and salt intake in male essential hypertension patients with obstructive sleep apnea hypopnea syndrome 

作者：屈丰雪1曾荣1于静1王佐广2程文立1

英文作者：Qu Fengxue1 Zeng Rong1 Yu Jing1 Wang Zuoguang2 Cheng Wenli1

单位：1首都医科大学附属北京安贞医院心内科高血压中心，北京100029；2首都医科大学附属北京安贞医院北京市心肺血管疾病研究所高血压研究室，北京100029

英文单位：1Hypertension Center of Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Hypertension Laboratory Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：阻塞性睡眠呼吸暂停低通气综合征；原发性高血压；最低血氧饱和度；24h尿钠

英文关键词：Obstructivesleepapneahypopneasyndrome;Essentialhypertension;Lowestoxygensaturation;24hurinarysodium

• 摘要：

• 目的 探讨男性原发性高血压合并阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者低氧血症与钠盐摄入量的相关性。方法 选取2016年1月至2018年1月在首都医科大学附属北京安贞医院心内科高血压中心住院的男性原发性高血压合并OSAHS患者325例，根据夜间最低血氧饱和度（LO2）分为对照组（147例，夜间LO2≥90%）和低氧血症组（178例，夜间LO2＜90%）。比较2组动态血压参数、代谢指标、呼吸暂停低通气指数（AHI）、夜间LO2、24 h尿钠等指标，并分析夜间LO2和24 h尿钠的相关性。结果 低氧血症组24 h平均收缩压、24 h平均心率、日间平均收缩压、日间平均舒张压、夜间平均收缩压、夜间平均舒张压(NDBP)、夜间平均心率(NHR)均高于对照组，差异均有统计学意义（均P＜0.05）。低氧血症组血尿素氮、血肌酐水平均高于对照组，差异均有统计学意义（均P＜0.05）。低氧血症组24 h尿钠和AHI水平高于对照组［（181±76）mmol/24 h比（154±67）mmol/24 h、（29.3±22.5）次/h比（2.3±0.8）次/h］，夜间LO2水平低于对照组［（80.9±9.1）%比（97.1±1.7）%］（均P＜0.05）。多元线性回归分析显示LO2与NHR、血尿素氮、餐后2 h血糖、NDBP、三酰甘油和24 h尿钠水平呈负相关，与高密度脂蛋白胆固醇呈正相关（均P＜0.05）。结论 原发性高血压合并OSAHS患者的夜间LO2与钠盐摄入量密切相关，控制患者的钠盐摄入量有助于改善患者的夜间低氧血症，对控制夜间血压和心率有重要意义。

• Objective To investigate the correlation between hypoxemia and salt intake in male essential hypertension patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Totally 325 male patients with essential hypertension complicated with OSAHS admitted to the Hypertension Center of Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University from January 2016 to January 2018 were enrolled. According to nocturnal lowest oxygen saturation(LO2), patients were divided into control group (147 cases, nocturnal LO2≥90%) and hypoxia group (178 cases, nocturnal LO2＜90%). The parameters of ambulatory blood pressure, metabolic indexes, apnea hypopnea index (AHI), nocturnal LO2 and 24 h urinary sodium were compared between the two groups, and the correlation between nocturnal LO2 and 24 h urinary sodium was analyzed. Results The 24 h mean systolic blood pressure, 24 h mean heart rate, daytime mean systolic blood pressure, daytime mean diastolic blood pressure, nocturnal mean systolic blood pressure, nocturnal mean diastolic blood pressure (NDBP) and nocturnal mean heart rate (NHR) in the hypoxia group were significantly higher than those in the control group (all P＜0.05). The levels of blood urea nitrogen and serum creatinine in the hypoxia group were higher than those in the control group (both P＜0.05). The levels of 24 h urinary sodium and AHI in the hypoxia group were higher than those in the control group［（181±76）mmol/24 h vs （154±67）mmol/24 h, （29.3±22.5）times/h vs （2.3±0.8）times/h］, and the level of nocturnal LO2 was lower than that in the control group［（80.9±9.1）% vs （97.1±1.7）%］（all P＜0.05）. Multiple linear regression analysis showed that LO2 was negatively correlated with levels of NHR, blood urea nitrogen, 2 h postprandial blood glucose, NDBP, triacylglycerol and 24 h urinary sodium (all P＜0.05). Conclusions Nocturnal LO2 in patients with essential hypertension complicated with OSAHS is closely related to sodium salt intake. Controlling sodium salt intake is helpful to improve nocturnal hypoxemia and is of great significance to control nocturnal blood pressure and heart rate.