The Related Investigation Of Obstructive Sleep Apnea Syndrome And Target Organ Damage In Patients With Hypertension

【[Objective】The aim of this study is to investigate the degree of target organs' damages in patients with hypertension suffering obstructive sleep apnea syndrome (OSAS) and analyze the impact of risk factors on target organ damages so as to provide the valuable clinical information for prevention and treatment of these patients.【Methods】75 outpatients and inpatients with hypertension were enrolled to investigate.The contents monitored included the general condition,sleep apnea and target organ function.The disease history,physical examination,echocardiography and biochemical examination were performed in all patients.The exclusion criteria were as follow:valvular heart diseases,congenital heart diseases,central sleep apnea syndrome,a serious long-term alcohol drunk,serious lung diseases,kidney diseases, brain diseases and the recent use of drugs for sleep.According to polysomnography monitoring,the patients were divided into 2 groups.One is experimental group,i.e., sleep apnea syndrome with hypertension including 46 cases,males 39 cases,females 7,age(61.5±5.6) years,and the other is control group,i.e.,with hypertension including 29 cases,males 22,females 7,age(62.8±5.8) years.The target organ functions were monitored in all patients.All quantitative data were expressed as x±s and analyzed by SPSS13.0 statistical package.Student t-test was applied in inter-group comparison of quantitative data and chi-square test was employed in inter-group comparison of qualitative data.P＜0.05 is considered statistically significant.The correlation analysis was performed between independent variable and dependent ariable.Linear correlation analysis was used when data were normal distribution and orderly variance,on the contrary,the rank correlation analysis were performed.When correlational coefficient r＞0.7,highly correlational relation between two variables was considered;when 0.7＞r＞0.4,moderate correlational relation between two variables,when r＜0.4,low correlation relation between two variables was.When the internal variables of experimental group were the normal distribution, we used the multiple linear regression analysis step by step(forward) and produced a regression equation,and then the risk factors were determined,with the entering standard a = 0.05 and the-excluded standardβ= 0.10.When the dependent variable was probability estimates and the independent variable was normal distribution,we applied the Logistic regression analysis(backward),and produced a regression equation,then the risk factors were determined,with the entering standard a = 0.05 and the excluded standardβ=0.10.【Result】Generally in terms of gender,age,smoking,drinking,blood press (SBP / DBP),duration of suffering from high blood pressure,body mass index(BMI), waist-hip ratio(WHR),renal function,total cholesterol(TC),LDL-C,HDL-cholestorol (HDL-C),triglyceride(TG ),fast plasma glucose(FPG),postprandial blood sugar (PPBS),comparisons between the experimental group and control group were not statistically difference.But,neck circumference,patients' the heart structure index, including interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricle myocardium(LVM),left ventricle myocardium index(LVMI);Blood vessel structure index:common carotid artery internal dimension(CCAId),common carotid artery intima-media thickness(CCA-IMT) in experimental group were higher than those in control group(p＜0.05),patients' carotid artery plaque score(CAPS) number,arrhythmia cordis number and cerebral vascular accident(CVA) number in experimental group were notably higher than those in control group.By correlation analysis,it was showed that the heart of the structure indicators were correlated with indicators of hypoxic-time moderately and highly,they were also correlated with indicators of degree of hypoxia moderately and highly and correlated with comprehensive indicators of hypoxia moderately,the indicators of vascular structural indicators of hypoxia beyond moderate.Cerebral vascular accident was a highly correlated with time indicators of hypoxia and was a moderately correlated with the degree indicators of hypoxia,arrhythmia incidence was correlated with time indicators and degree indicators of hypoxia with low-grade. By multiple linear regression analysis and Logistic regression analysis,it was showed that the changes in the structure of the heart,arrhythmia,peripheral vascular damage, CVA of OSAS patients with hypertension was the result of a combination of factors, and the degree and time of hypoxia have a direct correlation with the target organ damage in patients who were OSAS with hypertension and they were risk factors of the target organ damage of patients who were OSAS with hypertension and correlated with time indicators,degree indicators and comprehensive of hypoxia.【Conclusion】The sleep apnea syndrome patients with hypertension had more serious damage degree on target organ damage than the only hypertension ones,and the damage degree is closely related to long-term hypoxia and disturbance of re-oxygenation.So.there is a urgent need to adopt a variety of effective interventions to control and reduce the hazards brought by target organ damages due to hypertension. This is the allround report about the relevance between sleep apnea syndrome and hypertension target organ damage.The results of these studies will provide valuable information for further study on target organ damage in patients with hypertension.