阻塞性睡眠呼吸暂停低通气综合征合并肺栓塞的临床特点分析  

Clinical Feature Analysis of Obstructive Sleep Apnea-hypopnea Syndrome with Pulmonary Embolism

作　　者：周仲伟[1] 邹俊[1] 

机构地区：[1]四川省医学科学院.四川省人民医院呼吸内科,成都610072

出　　处：《华西医学》2014年第10期1801-1804,共4页West China Medical Journal

摘　　要：目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对肺血栓栓塞症(PTE)患者病情严重程度和干预措施的影响。方法以2006年1月-2012年12月期间住院治疗的合并OSAHS(n=16)或不合并OSAHS(n=20)的PTE患者为研究对象,回顾性分析两组患者在动脉血气分析、呼吸暂停低通气指数和夜间最低脉搏氧饱和度(LSpO2)以及临床干预措施等方面是否存在差异。结果相对于单纯的PTE患者,合并OSAHA的PTE患者年龄较低[(53.4±12.1)、(64.5±9.8)岁,P=0.005],但体质量指数[(29.3±2.2)、(26.1±3.3)kg/m2,P=0.002)和吸烟指数(150±24、101±18,P<0.001)均较高。此外,合并OSAHS组患者LSpO2明显降低[(71.7±8.3)、(79.4±7.1)mm Hg(1 mm Hg=0.133 kPa),P=0.005],且栓塞累及的肺段数量更多[(8±3)、(5±2)个,P=0.001]。两组均采用抗凝和(或)溶栓治疗,但无创正压通气(CPAP)在合并OSAHS的PTE患者中应用更显著。结论合并OSAHS的PTE患者年龄相对较小但病情较重,临床上需要采取以抗凝和CPAP为主的综合治疗。Objective To observe the impact of obstructive sleep apnea-hyponea syndrome（OSAHS） on the severity of pulmonary thromboembolism（PTE） and its treatment strategies. Methods PTE patients hospitalized in our department between January 2006 and December 2012 were screened for this study, including 16 patients with OSAHS and 20 patients without OSAHS, and the difference in clinical characteristics such as arterial blood gas, apnea-hypopnea index, lowest pulse oxygen saturation（LSpO2） and treatment methods were analyzed and compared between the two groups. Results As compared to PTE patients without OSAHS, the age of patients was lower [（53.4 ± 12.1）,（64.5 ± 9.8） years; P=0.005], while body mass index [（29.3 ± 2.2）,（26.1 ± 3.3） kg/m^2, P=0.002] and smoking index（150 ± 24, 101 ± 18; P 0.001） were higher in PTE patients with OSAHS. Additionally, signifi cantly lower LSpO2 [（71.7 ± 8.3）,（79.4 ± 7.1） mm Hg（1 mm Hg=0.133 kPa）; P=0.005] and more lung segments（8 ± 3, 5 ± 2; P=0.001） were involved in PTE patients with OSAHS. In this cohort, all patients received anticoagulation and/or thrombolysis treatment, but the rate of continuous positive airway pressure（CPAP） ventilation application was signifi cantly higher in PTE patients with OSAHS. Conclusion PTE patients with OSAHS have relatively lower age but serious condition, and both anticoagulation and CPAP should be used in the clinical treatment.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 肺血栓栓塞症 病情程度 治疗 

分 类 号：R766[医药卫生—耳鼻咽喉科]