COPD合并OSAHS重叠综合征患者临床特征研究

Clinical Chraracteristics of OSAHS-COPD Overlap Syndrome Patients

中文关键词: 阻塞性睡眠呼吸暂停低通气综合征  慢性阻塞性肺病  重叠综合征  肺动脉高压

英文关键词: obstructive sleep apnea-hypopnea syndrome (OSAHS)  chronic obstructive pulmonary disease (COPD)  overlap syndrome (OS)  pulmonary arterial hypertension

中文摘要:

      目的 观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并慢性阻塞性肺疾病(COPD)重叠综合征(OS)患者临床特征,为其诊断及并发症的研究提供参考.方法 选择2012年7月-2014年12月收治的OSAHS、COPD和OS患者各30例,同时设立健康对照组30例.检测并比较各组临床资料、多导睡眠监测、肺功能、心超、和肺动脉收缩压(sPAP)情况.结果 4组中OS组的氧分压(Pa02)、夜间最低氧饱和度(LSaO2)和一秒用力呼气容积(FEV 1％)最低,sPAP最高(P＜0.05).OSAHS与COPD对sPAP有正交互作用(F=5.88,P=0.02).OS组的sPAP分别与腰围和AHI呈正相关(r=0.22和r=0.21,均P＜0.05),而与FEV1/FVC和SaO2呈负相关(r=-0.48,P＜0.01;r=-0.23,P＜0.05).结论 OS患者的低氧和肺动脉高压程度较重,患者的肺动脉压与向心性肥胖、夜间呼吸暂停和肺功能均有高度相关性.

英文摘要:

      Objective To observe the clinical characteristics of OSAHS-COPD overlap syndrome (OS) patients so as to provide reference for the diagnosis and the study of complication occurrence.Methods 4 groups were enrolled in the study,including 30 patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),30 with chronic obstructive pulmonary disease (COPD),30 with OS,who were hospitalized during the period from July,2012 to Dec.,2014,and 30 norm as the control;polysomnography (PSG),cardiac ultrasound,detection of pulmonary function and pulmonary artery systolic pressure (sPAP) were made to the cases in the 4 groups and the data of each group were comparatively studied.Results The oxygen pressure (PaO2),lowest nocturnal oxygen saturation (LSaO2) and forced expiratory volume in 1 second (FEV1％) in OS group were the lowest and those in sPAP group were the highest among the 4 groups (P＜0.05);OSAHS and COPD were in positive interaction with sPAP (F=5.88,P=0.02);sPAP in OS group was in positive correlation to waist circumference (r=0.22,P=0.04) and AHI (r=0.21,P=0.04) while in negative correlation to FEV1/FVC (r=-0.48,P＜0.01) and SaO2 (r=-0.23,P=0.04).Conclusions Hypoxia and pulmonary arterial hypertension in OS patients are more severe,and the pulmonary artery pressure is highly correlated to central obesity,nocturnal apnea and pulmonary function.