規范睡眠呼吸暫停相關性高血壓的診斷和治療_《中國呼吸與危重監護雜志》

作者：

陳寶元 ¹ , 何權瀛 ²

1 天津醫科大學總醫院呼吸科( 天津 300052);;
2 北京大學人民醫院呼吸科( 北京 100044)通信作者: 何權瀛, E-mail: hxk313 @ 126. com;;
陳寶元, E-mail:cbynew@ 126. com;

關鍵詞：

睡眠呼吸暫停高血壓診斷治療

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由于高血壓的高患病率與高致殘致死率, 已經成為我國重點防治的心血管疾病和社會普遍關注的重大公共衛生問題之一。大量流行病學、臨床和基礎研究已證實睡眠呼吸暫停低通氣綜合征( sleep apnea-hypopnea syndrome, SAHS) 與高血壓發病和療效關系密切[ 1-8 ] , 是高血壓發生的主要病因之一, 由此“睡眠呼吸暫停相關性高血壓”一詞便應運而生[ 9-1 0] , 它是指由SAHS 引發和加重的高血壓。本期刊載的“阻塞性睡眠呼吸暫停相關性高血壓臨床診斷和治療專家共識”( 以下簡稱共識) , 為睡眠呼吸暫停相關性高血壓的診治提供了規范性的指導意見, 對推動我國該領域的防治水平有重要作用。我們期望“共識”能為讀者認識和防治睡眠呼吸暫停相關性高血壓提供必要的指導和幫助, 使我國為數眾多的睡眠呼吸暫停相關性高血壓患者得到規范的診治。

引用本文： 陳寶元,何權瀛. 規范睡眠呼吸暫停相關性高血壓的診斷和治療. 中國呼吸與危重監護雜志, 2013, 12(5): 433-434. doi: 復制

1.	Guilleminault C, Eldridge F, Dement WC. Insomnia with sleep apnea: a new syndrome. Science, 1973, 181: 856 -858.
2.	Tilkian AG, Guilleminault C, Schroeder JS, et al. Hemodynamics in sleep-induced apnea. Studies during wakefulness and sleep. Ann Intern Med, 1976, 85: 714 -719.
3.	Kales A, Bixler EO, Cadieux RJ, et al. Sleep apnoea in a hypertensive population. Lancet, 1984, 2 : 1005-1008.
4.	Lavie P, Ben-Yosef R, Rubin AE, et al. Prevalence of sleep apnea syndrome among patients with essential hypertension. Am Heart J,1984, 108 : 373-376.
5.	Young T, Peppard PE, Palta M, et al. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med, 1997, 157 : 1746 -1752 .
6.	Logan AG, Perlikowski SM, Mente A, et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens, 2001, 19: 2271-2277.
7.	Peppard PE, Young T, Palta M, et al. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med, 2000 , 342: 1378-1384.
8.	Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the Korean Health and Genome Study. Am J Hypertens, 2007, 20: 819-824 .
9.	Fletcher EC. Invited review: Physiological consequences of intermittent hypoxia: systemic blood pressure. J Appl Physiol, 2001,90: 1600-1605.
10.	Weiss JW, Liu MD, Huang J. Physiological basis for a causal relationship of obstructive sleep apnea to hypertension. Exp Physiol,2007, 92: 21 -26 .
11.	Bazzano LA, Khan Z, Reynolds K, et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension, 2007, 50: 417-23.
12.	Alajmi M, Mulgrew AT, Fox J, et al. Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomizedcontrolled trials. Lung, 2007, 185 : 67-72.
13.	Chobanian AV, Bakris GL, Black HR, et al. National Heart, Lung,and Blood Institute Joint National Committee on Prevention,Detection, Evaluation, and Treatment of High Blood Pressure;National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA, 2003, 289: 2560-2572.
14.	Young T, Palta M, Dempsey J, et al. The occurrence of sleepdisordered breathing among middle-aged adults. N Engl J Med,1993, 29, 328: 1230-1235.
15.	He J, Kryger MH, Zorick FJ, et al. Mortality and apnea index in obstructive sleep apnea. Chest, 1988, 94: 9-14.
16.	Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association /American College of Cardiology Foundation Scientific Statement from theAmerican Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing.J Am Coll Cardiol, 2008, 52: 686-717 .
17.	中華醫學會呼吸病學分會睡眠呼吸疾病學組. 睡眠呼吸暫停人群高血壓患病率的多中心研究. 中華結核和呼吸雜志, 2007 ,30: 894-897 .

1. Guilleminault C, Eldridge F, Dement WC. Insomnia with sleep apnea: a new syndrome. Science, 1973, 181: 856 -858.
2. Tilkian AG, Guilleminault C, Schroeder JS, et al. Hemodynamics in sleep-induced apnea. Studies during wakefulness and sleep. Ann Intern Med, 1976, 85: 714 -719.
3. Kales A, Bixler EO, Cadieux RJ, et al. Sleep apnoea in a hypertensive population. Lancet, 1984, 2 : 1005-1008.
4. Lavie P, Ben-Yosef R, Rubin AE, et al. Prevalence of sleep apnea syndrome among patients with essential hypertension. Am Heart J,1984, 108 : 373-376.
5. Young T, Peppard PE, Palta M, et al. Population-based study of sleep-disordered breathing as a risk factor for hypertension. Arch Intern Med, 1997, 157 : 1746 -1752 .
6. Logan AG, Perlikowski SM, Mente A, et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens, 2001, 19: 2271-2277.
7. Peppard PE, Young T, Palta M, et al. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med, 2000 , 342: 1378-1384.
8. Kim J, Yi H, Shin KR, et al. Snoring as an independent risk factor for hypertension in the nonobese population: the Korean Health and Genome Study. Am J Hypertens, 2007, 20: 819-824 .
9. Fletcher EC. Invited review: Physiological consequences of intermittent hypoxia: systemic blood pressure. J Appl Physiol, 2001,90: 1600-1605.
10. Weiss JW, Liu MD, Huang J. Physiological basis for a causal relationship of obstructive sleep apnea to hypertension. Exp Physiol,2007, 92: 21 -26 .
11. Bazzano LA, Khan Z, Reynolds K, et al. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension, 2007, 50: 417-23.
12. Alajmi M, Mulgrew AT, Fox J, et al. Impact of continuous positive airway pressure therapy on blood pressure in patients with obstructive sleep apnea hypopnea: a meta-analysis of randomizedcontrolled trials. Lung, 2007, 185 : 67-72.
13. Chobanian AV, Bakris GL, Black HR, et al. National Heart, Lung,and Blood Institute Joint National Committee on Prevention,Detection, Evaluation, and Treatment of High Blood Pressure;National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA, 2003, 289: 2560-2572.
14. Young T, Palta M, Dempsey J, et al. The occurrence of sleepdisordered breathing among middle-aged adults. N Engl J Med,1993, 29, 328: 1230-1235.
15. He J, Kryger MH, Zorick FJ, et al. Mortality and apnea index in obstructive sleep apnea. Chest, 1988, 94: 9-14.
16. Somers VK, White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association /American College of Cardiology Foundation Scientific Statement from theAmerican Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing.J Am Coll Cardiol, 2008, 52: 686-717 .
17. 中華醫學會呼吸病學分會睡眠呼吸疾病學組. 睡眠呼吸暫停人群高血壓患病率的多中心研究. 中華結核和呼吸雜志, 2007 ,30: 894-897 .

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規范睡眠呼吸暫停相關性高血壓的診斷和治療

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