重叠综合征患者夜间缺氧与生活质量评分的相关性研究  

Correlation between Nocturnal Hypoxemia and Life Quality Score in Patients with Overlap Syndrome

作　　者：吴巧珍[1,2] 胡晓蕴[1,2] 姚明[1,2] 董凌云[1,2] 张希龙[3] 

机构地区：[1]江苏省南通大学附属吴江医院 [2]吴江市第一人民医院呼吸科,215200 [3]南京医科大学第一附属医院呼吸科,210029

出　　处：《医学研究杂志》2012年第7期118-123,共6页Journal of Medical Research

摘　　要：目的探讨慢性阻塞性肺病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS),即重叠综合征(OS)患者的夜间缺氧与生活质量的相关性。方法观察对象105例,其中COPD组30例,OSAHS组30例,OS组25例,正常对照组20例,所有患者均行肺功能测定和多导睡眠呼吸监测(PSG),填写生活质量呼吸问卷和贝克抑郁量表(BDI),并对各组数据做统计学单因素方差分析,同时对生活质量评分和贝克抑郁评分的相关因素做相关分析和多元回归分析。结果在比较COPD组和OS组第1秒钟用力呼气容积占预计值的百分比(FEV1占预计值%)、第1秒钟用力呼气容积占用力肺活量的百分比(FEV1/FVC)差异无显著性的情况下,OS组的Epworth评分、浅睡眠所占百分率(S1+S2)%、微觉醒指数、呼吸暂停低通气指数(AHI)、血氧饱和度<90%的时间占总监测时间的百分比(TS90%)、氧减指数(ODI)、氧减事件时间/小时、均明显高于COPD组(P均<0.05)。OS组的最长呼吸暂停时间(LAT)、生活质量评分、BDI评分均明显高于其他3组(P均<0.05),而最低血氧饱和度(LSaO2)、平均血氧饱和度(MSaO2)则明显低于其他3组(P均<0.05)。OS组生活质量评分与TS90%、ODI、氧减事件时间/小时具有很好的相关性(相关系数分别为0.543、0.651、0.769,P<0.05);而且这3种缺氧指标和BDI同样具有很好的相关性(相关系数分别为0.490、0.568、0.622,P均<0.05)。多元回归分析显示,OS组患者生活质量评分与氧减事件时间/小时正相关(P<0.05),AHI、微觉醒指数、BMI、睡眠效率等未进入回归方程,而BDI评分则与氧减事件时间/小时和微觉醒指数正相关(P<0.05)。结论重叠综合征患者与单纯的COPD患者和OSAHS患者相比,睡眠相关的缺氧程度更严重,因夜间缺氧而引起健康等相关生活质量情况更差,抑郁程度更重。Objective To study the correlation between nocturnal hypoxemia and the life quality score in patients with overlap syndrome （OS）. Methods One hundred and five subjects were detected by polysomnography（PSG） and lung function, then they were divided into 4 groups according to apnea hypopnea index （AHI） and lung function; 30 with chronic obstructive pulmonary disease（ COPD）, 30 with obstructive sleep apneahypopnea syndrome（ OSAHS）, 25 with OS, 20 normal subjects in group control. The quality of life respiratory questionnaire score and Beck Depression Inventory （BDI） score were collected from all the subjects. The analysis of the data from each group was assessed by one way ANOVA. The correlation between life quality score, BDI score and some factors were documen- ted by performing correlation analysis and multiple linear regression analysis. Results The Epworth sleepiness score, the percentage of light sleep stage （S1 ＋ $2） , arousal index, AHI, time spent below oxygen saturation of 90% （ TS90% ） , oxygen desaturation index （ODI） , time of desaturation events per hour in patients with OS were significantly higher than those in COPD patients （P 〈0.05）. The longest apnea time （LAT） , life quality score and BDI score in OS group were higher than the other three groups. The levels of lowest oxy- gen saturation （ LSaO2 ） and mean oxygen saturation （ MSaO2 ） in patients with OS were much lower than the others （ P 〈 0.05 ）. However there were no significant differences in forced expiratory volume in one second （FEV1% of predicted） and the percentage of FEV1 than forced vital capacity （FEV1/FVC） between COPD and OS groups and no differences in AHI between OSAHS and OS groups. The correlation coefficients between life quality score and TS90% , ODI, time of desaturation events per hour were 0. 543,0. 651 and 0. 769 respec- tively（P 〈0.05）. Also the three indexes of desaturation were significantly correlated with the patient＇s BDI respectively （0.

关 键 词：慢性阻塞性肺病 阻塞性睡眠呼吸暂停低通气综合征 重叠综合征 夜间低氧血症 生活质量 

分 类 号：R697.32[医药卫生—泌尿科学]