透過您的圖書館登入
IP:3.85.211.2
  • 學位論文

睡眠呼吸障礙病患清晨血壓值之變化反應睡眠品質、血管發炎狀態及代謝症候群之探討

The Morning Blood Pressure Values’ Changes Reflect Sleep Quality, Inflammatory and Metabolic Syndrome in Sleep Disorder Breathing Patients

指導教授 : 袁素娟

摘要


研究背景:急性心肌梗塞及腦血管疾病合併血壓竄升的現象好發於清晨,這現象最近經證實與睡眠時間有著緊密的關連性。再者文獻也指出,睡眠呼吸障礙亦是全身發炎現象、肥胖、糖尿病的獨立相關因子,它能引發睡覺時急性血壓震盪及長期累積下來造成血壓持續上揚。因此我們假設睡眠呼吸障礙病患若夜眠前後血壓會明顯上升將可預期睡眠品質較差,且可能會有全身血管內皮發炎及代謝異常的現象。 方法與結果:本研究甄收263位主訴睡眠不佳但無其他內科或身心疾病之病患在接受整夜的睡眠檢查後,再根據2004年行政院衛生署所公佈代謝症候群對血壓之臨床診斷準則,收縮壓 >= 130mmHg及舒張壓 >= 85mmHg者,再將所有病患分成兩組:( 1 ) Group 1晨間血壓 < 130 / 85mmHg ( 2 ) Group 2晨間血壓 >= 130 / 85mmHg。 結果發現:在比對兩組資料時,發現睡眠呼吸障礙較嚴重者其晨間血壓 >= 130 / 85mmHg較顯著(p<0.001),且年齡較長(p<0.001)、身體質量指數>24 kg / m2(p<0.001)、頸圍較粗(p<0.001)、睡眠品質明顯較差(p<0.001)、全身血管內皮發炎現象較嚴重(p<0.001)、及符合代謝症候群的條件之特性(p<0.001)。 結論:倘若經過夜眠後,血壓 >= 130 / 85 mmHg者,將有較差睡眠品質、會出現較嚴重全身發炎狀態及代謝症候群。

並列摘要


Acute myocardial infarction (AMI) and cerebrovascular disease(CVA) associated with hypertension have been shown peak onset in the early morning . Eventually, nocturnal sleep was recently confirmed to be related to the morning surge in blood pressure, and sleep disorder breathing is an independent factor with inflammatory, obesity and diabetes mellitus. Then, the purpose of the study is to investigate if the elevated blood pressure in patient with sleep disorder breathing through one night sleep, will predict the patient sleep quality and the inflammatory status , and metabolic disorder. The subjects were recruited from a district hospital of middle Taiwan who were admitted to OPD of sleep clinics, from September, 2003 to March, 2005. The study was a purposive sampling design and the total participants were 263 patients. Then according the 2004 years The Medical Bureau of Administrative Yuan make public “Metabolic syndrome” about blood pressure criteria is systolic blood pressure >= 130mmHg and Diastolic Blood Pressure) >= 85mmHg to was distributed into two groups. Group 1 is blood pressure < 130 / 85 mmHg, Group 2 is blood pressure >= 130 / 85 mmHg. Data collection was used by polysomnography (PSG) and laboratory data, the data analysis was used by SPSS 10.0 for the Window. The findings showed the Group 2 participants were elder(p<0.001),BMI>24 kg/m2(p<0.001)and coexisted with poor sleep quality(p<0.001), inflammatory status(p<0.001) and metabolic syndrome(p<0.001).

參考文獻


蔡政楒(2000)˙睡眠圖譜˙台北:合記。
蔡崇煌、黃素雲、羅永杰、林高德(2003)˙新陳代謝症候群˙基層醫學,19(11),270-273。
何逸僊(2003)˙動脈粥狀硬化之病理觀˙傳統醫學雜誌,14,58-60。
郝立智(2003)˙肥胖正面面觀˙當代醫學,30(8),61-73。
陳亮恭、許碧珊、林明憲、陳稚均、陳振文、黃信彰、邱淑緹(2005)˙宜蘭鄉村地區中老年人代謝症候群與胰島素阻抗性之關係˙北市醫學雜誌,2(1),32-40。

被引用紀錄


徐雪珍(2013)。運用決策樹演算法於阻塞型睡眠呼吸中止症疾病之預測探討〔碩士論文,中山醫學大學〕。華藝線上圖書館。https://doi.org/10.6834%2fCSMU.2013.00009

延伸閱讀