24例合并肺血栓栓塞症的阻塞性睡眠呼吸暂停低通气综合征患者临床特点及治疗分析  

Clinical Features and Management of OSAHS Patients Complicated with Pulmonary Thromboembolism

作　　者：张向峰[1] 丁少芳[1] 朱光发[1] 杨京华[1] 刘双[1] 

机构地区：[1]首都医科大学附属北京安贞医院呼吸科,北京100029

出　　处：《中国呼吸与危重监护杂志》2011年第6期568-571,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的调查2004年1月至2008年12月期间阻塞性睡眠呼吸暂停低通气综合征(OSAHS)住院患者合并肺血栓栓塞症(PTE)的患病率,研究合并PTE对于OSAHS患者起病及病情严重程度的影响,以及所采取的临床干预方法。方法分析24例合并PTE的住院OSAHS患者的一般情况、吸烟指数、是否合并高血压、肺动脉高压和下肢深静脉血栓(DVT)、栓塞面积、动脉血气分析结果、呼吸暂停低通气指数(AHI)、最低夜间脉搏容积血氧饱和度(LSpO2)和所接受的治疗措施,与30例未合并PTE的OSAHS患者进行比较。结果 2.44%(31/1268)的住院OSAHS患者合并PTE,合并PTE的OSAHS患者平均AHI高于未合并PTE的OSAHS患者[(27.8±11.6)次/h比(18.2±8.1)次/h,P=0.038],而LSpO2则低于未合并PTE者[(78.4±8.5)%比(85.2±7.9)%,P=0.035]。临床干预方面,两组均采用无创正压通气(CPAP)治疗,合并PTE的OSAHS患者在此基础上应用抗凝和/或溶栓治疗。结论住院OSAHS患者合并PTE的发病率较高,合并PTE的OSAHS患者睡眠呼吸紊乱程度及继发的夜间低氧血症较严重,临床上需要采取以抗凝和CPAP为主的综合治疗。Objective To invesitgate the prevalence of pulmonary thromboembolism（PTE） in hospitalized patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） from January 2004 to December 2008,and analyze its impact on the severity of OSAHS.Methods Demographic and clinical characteristics of 24 OSAHS patients complicated with PTE were analyzed.30 OSAHS patients without PTE were served as controls.Results PTE was detected in 2.44%（31/1268） of the OSAHS patients.When compared with the OSAHS patients without PTE,the OSAHS patients with PTE had a significantly higher apnea hypopnea index（AHI） [（27.8±11.6）/h vs.（18.2±8.1）/h,P=0.038] and a lower LSpO2（lowest saturated pulse arterial oxygen level） [（78.4±8.5）% vs.（85.2±7.9）%,P=0.035].Both groups received continuous positive airway pressure（CPAP） ventilation.Anticoagulation and/or thrombolysis treatment were used in the OSAHS patients with PTE.Conclusions We found a higher prevalence of PTE in patients with OSAHS.Compared with those without PTE,OSAHS patients with PTE have more severe sleep apnea-hypopnea and hypoxemia in sleep.Comprehensive treatments including anticoagulation and CPAP should be used in these patients.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 肺血栓栓塞症 治疗 

分 类 号：R56[医药卫生—呼吸系统]