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目的:探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者体质指数（BMI）和日间嗜睡在睡眠紊乱对血压影响中的多重中介作用。方法:以2015年1月至2019年8月在北京大学国际医院睡眠中心首次确诊的530例成年住院OSAHS患者为研究对象，收集患者的多导睡眠图监测数据和爱泼沃斯嗜睡量表数据，基于结构方程模型构建多重中介模型，并采用偏差校正的百分位Bootstrap方法进行多重中介效应的分析和检验。结果:基于结构方程模型的多重中介模型拟合度良好（n χ2=72.827，n dF=40，χn 2/dF=1.821，n CFI=0.998，n RMSEA=0.039），睡眠紊乱对血压存在正向直接效应，其标准化效应值为0.218（95%n CI：0.117~0.310），BMI和日间嗜睡程度在睡眠紊乱对血压的影响上起正向的部分中介作用，二者的标准化中介效应分别为0.116（95%n CI：0.069~0.164）和0.028（90%n CI：0.002~0.059），且BMI所起的中介效应大于日间嗜睡所起的中介效应，总中介效应占总效应的比例为39.67%。n 结论:OSAHS睡眠紊乱可以直接引起血压升高，BMI和日间嗜睡在其中起并行多重中介作用，且BMI的中介作用更大。“,”Objective:To explore the mediation effects of body mass index (BMI) and daytime sleepiness on the relationship between sleep disturbance and blood pressure in Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) patients.Methods:A total of 530 adult hospitalized OSAHS patients, diagnosed for the first time from January 2015 to August 2019 in the Sleep Center of Peking University International Hospital, were selected as the research objects, and the patients′ polysomnography data and Epworth sleepiness scale data were collected. The analysis and test of multiple mediation effects were carried out by the bias-corrected Bootstrap method, based on the structural equation model.Results:The multiple mediation model based on the structural equation model fitted well (n χ2=72.827, n dF=40, χn 2/dF=1.821, n CFI=0.998, n RMSEA=0.039). Sleep disturbance had a significant positive effect on the blood pressure, and the standardized effect was 0.218 (95%n CI: 0.117-0.310). BMI and daytime sleepiness both played positive partial mediation roles between the sleep disturbance and blood pressure, and their standardized mediation effects were 0.116 (95%n CI: 0.069-0.164) and 0.028 (90%n CI: 0.002-0.059), respectively. And the mediation effect of BMI was greater than the mediation effect of daytime sleepiness (unstandardized estimate 0.034, 95%n CI: 0.010-0.061). The total mediation effect accounted for 39.67% of the total effect.n Conclusions:Sleep disturbance can directly cause the rise of blood pressure. BMI and daytime sleepiness have parallel multiple mediation effects between the sleep disturbance and blood pressure, and the BMI has a greater mediation effect.