慢性阻塞性肺病与阻塞性睡眠呼吸暂停综合征关系研究  

Study of the relationship between chronic obstructive pulmonary disease and Obstructive sleep Apnea syndrome

作　　者：宋玉玲[1] 何忠明[1] 韩芳[2] 李静[2] 韩旭[2] 阿布力克木.吐尔逊 安培[2] 

机构地区：[1]克拉玛依市中心医院呼吸科,新疆克拉玛依834000 [2]北京大学人民医院呼吸科,北京100044

出　　处：《临床肺科杂志》2009年第7期880-882,共3页Journal of Clinical Pulmonary Medicine

基　　金：克拉玛依市科技经费支助项目(2007SK-21)

摘　　要：目的调查住院和门诊COPD患者中OSAS的患病率及OSAS患者中COPD的患病率,探讨COPD与OSAS之间的关系,分析重叠综合征患者睡眠呼吸紊乱的特点。方法对200例稳定期的COPD患者经问卷、爱波沃斯(ESS)评分及家庭血氧饱和度监测,对氧减饱和指数大于5或爱波沃斯(ESS)评分大于或等于10的患者进行多导生理记录仪睡眠呼吸监测(PSG)。结果门诊COPD患者中OSAS的患病率为2.5%,住院COPD患者中OSAS患病率为6.7%,OSAS患者中COPD的患病率为11.2%。重叠综合征患者与单纯OSAS患者在夜间平均氧饱和度、呼吸暂停指数、低通气指数等方面差异有显著性(P<0.01)。结论COPD与OSAS两者之间没有必然联系,重叠综合征患者夜间呼吸紊乱模式以肺泡通气不足和肺泡低通气为主而非呼吸暂停,重叠综合征患者睡眠中低氧程度比单纯OSAS患者更严重。Objective To study the prevalence of obstructive apnea-hypopnea syndrome （OSAS） with chronic obstructive pulmonary disease （COPD） in hospital and in clinic, the prevalence of COPD in SHAS, to define the relationship between COPD and OSAS, and to analyze the clinical features of sleep-disordered breathing in overlap syndrome patients. Methods 200 patients with stable COPD were screened for SDB using questionnaire, epworth sleep scale （ESS） and home pulse oximeter testing. Those with ESS ≥ 10 or oxygen desaturation over 3% per hour sleep 〉 5 times were under further PSG testing. The data came from the results of sleep-disordered breathing with COPD patients in the department of pulmonary medicine of our hospital since 1998 ,who had confirmed diagnosis of obstructive sleep apnea syndrome in our hospital. Results The prevalence of OSAS with COPD was 2.5% in clinic ,was 6. 7% in hospital. The prevalence of COPD in OSAS was 11. 2% ,which was similar to common people. There were statistically significant correlations between overlap syndrome and OSAS on hypopnea index, apnea index and MSaO2. Conclusion There is no relationship between COPD and OSAS, the major pattern of sleep-disordered breathing in overlap syndrome patients is hypoventilation and hypopnea, and not apnea. Overlap syndrome （OS） patients have more hypoxemia in sleep than OSAS.

关 键 词：慢性阻塞性肺疾病(COPD) 阻塞性睡眠呼吸暂停低通气综合征(OSAS) 氧减饱和指数(ODI4) 呼吸紊乱指数 (RDI) 

分 类 号：R766[医药卫生—耳鼻咽喉科] R563.9[医药卫生—临床医学]