TY - JOUR T1 - 持续气道正压改善血压和血清中的阻塞性睡眠呼吸暂停与高血压心血管JF生物标志物 - 欧洲呼吸杂志JO - EUR呼吸杂志DO - 10.1183 / 13993003.03687-2020 SP - 2003687 AU - 雷，梅西美施AU - 谢洪发AU - 林，大卫炽亮AU - 刘钜凯盟 - 成龙，卡门咏诗AU - IP，玛丽秀曼Y1 - 2021年1月1日UR - HTTP：//www.qdcxjkg.com/content/early/2021/03/25/13993003.03687-2020.abstract N2 - 理由阻塞性睡眠呼吸暂停（OSA）对减少心血管危险治疗的影响尚不清楚。这项研究旨在探讨对动态血压（BP）和亚临床心肌损伤与OSA和hypertension.Methods高血压的受试者持续气道正压（CPAP）需要至少三种抗高血压药物和中，重度OSA的效果入选。合格的受试者被随机分配（1:1）以接受CPAP治疗或对照（无CPAP）8周。相比较于动态血压和血清标志物的变化。Stratified analysis according to circadian BP pattern was performed.Main results Ninety two subjects (75% men; age, 51±8 years; apnoea-hypopnoea index 40±8 events·h−1, taking average of 3.4 anti-hypertensive drugs [range 3–6]) were randomised. The group on CPAP treatment, compared to the control group, demonstrated significant reduction in 24-h systolic BP (−4.4 mmHg, 95% CI −8.7 to −0.1, p=0.046), 24-h diastolic BP (−2.9 mmHg, 95% CI −5.5 to −0.2, p=0.032), daytime systolic BP (−5.4 mmHg, −9.7 to −1.0, p=0.016) and daytime diastolic BP (−3.4 mmHg, 95% CI −6.1 to −0.8, p=0.012). CPAP treatment was associated with significant BP lowering only in non-dippers, but not in dippers. Serum troponin I (mean difference −1.74 pg·mL−1, 95% CI −2.97 to −0.5, p=0.006) and brain natriuretic peptide (−9.1 pg·mL−1, 95% CI −17.6 to −0.6, p=0.036) were significantly reduced in CPAP compared to control group.Conclusion In a cohort with OSA and multiple cardiovascular risk factors including difficult-to-control hypertension, short-term CPAP treatment improved ambulatory BP and alleviated subclinical myocardial injury and strain.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Lui has nothing to disclose.Conflict of interest: Dr. Tse has nothing to disclose.Conflict of interest: Dr. LAM has nothing to disclose.Conflict of interest: Dr. Lau reports grants, personal fees and non-financial support from Boerhinger Ingelheim, grants and non-financial support from Pfizer, grants from Sanofi, grants from Amgen, non-financial support from Eisai, outside the submitted work.Conflict of interest: Dr. Chan has nothing to disclose.Conflict of interest: M. Ip has nothing to disclose. ER -