慢性阻塞性肺病与重叠综合征患者肺功能的比较  

Comparison of pulmonary function between chronic obstructive pulmonary disease and overlap syndrome in patients

作　　者：李群[1] 王彦[1] 曹洁[1] 周宁[1] 王杰[1] 郭美南[1] 

机构地区：[1]天津医科大学总医院呼吸科,300052

出　　处：《天津医药》2015年第7期753-756,共4页Tianjin Medical Journal

基　　金：国家十二五科技支撑计划课题资助(2012BAI05B02)

摘　　要：目的比较单纯慢性阻塞性肺病(COPD)与重叠综合征(OS)患者的肺通气功能与气道阻力。方法纳入2012年10月—2014年8月就诊于天津医科大学总医院呼吸科患者194例,均经询问病史、日间肺功能检查及夜间多导睡眠(PSG)监测,根据PSG及肺功能检查结果将其分为OS组78例,COPD组76例,健康对照组40例。分别比较3组受试者肺通气功能指标以及脉冲振荡肺功能指标。结果肺通气功能指标中,OS组与COPD组比较呼气峰流速(PEF)、剩余75%用力肺活量时呼气流速(MEF75)明显降低(P<0.05),其中OS[睡眠呼吸暂停低通气指数(AHI)≥30次/h]患者与COPD组比较,除了PEF、MEF75明显降低外,剩余25%用力肺活量时呼气流速(MEF25)、最大呼气中期流量(MMEF)也明显降低(P<0.05)。脉冲振荡肺功能指标中,OS组与COPD组比较,呼吸总阻抗(Zrs)、共振频率(Fres)、振荡频率为5 Hz时的黏性阻力(R5)、振荡频率为20 Hz时的黏性阻力(R20)明显增加(P<0.05),OS(AHI≥30次/h)患者较COPD组除了Zrs、Fres、R5、R20明显增加外,R5与R20的差值(R5-R20)、振荡频率为5Hz时的弹性阻力(X5)亦明显增加(P<0.01)。结论 OS比COPD患者气道阻塞严重,重度睡眠呼吸紊乱可以加重COPD患者的小气道阻塞。Objective To explore the difference in pulmonary function between overlap syndrome and chronic obstructivepulmonary disease（COPD） in patients. Methods One-hundred-ninty-four patients came from respiratory department in TianjinMedical University General Hospital, from October 2012 to August 2014, were included in this study. After inquisition of medicalhistory, evaluation of lung function and polysomnography（PSG）, patients were divided into overlap syndrome（OS, n=78） group,COPD group（n=76） and healthy control group（n=40）. The indexes of lung function and the pulse oscillation index of pulmonaryfunction were compared between three groups. Results Values of the peak expiratory flow rate（PEF） and the remaining 75%FVC when expiratory flow rate（MEF75） were significantly decreased in OS group than those of COPD group（P〈0.05）. Patientswith sleep apnea hypopnea index（AHI） ≥30 times/h showed significantly decreased MEF25 and the maximum mid expiratoryflow（MMEF） in OS group than those of COPD group（P〈0.05）. Values of the total impedance（Zrs）, the resonant frequency（Fres）,viscosity resistance when oscillation frequency was 5 Hz（R5）, R20 were significantly increased in OS group than those of COPDgroup（P〈0.05）. Patients with AHI ≥30 times/h were increased significantly than COPD group in R5-R20 and X5 besides Zrs,Fres, R5, R20. Conclusion There is more serious airway obstruction in patients with OS than that in patients with COPD. Severesleep disordered breathing can aggravate small airway obstruction in patients with COPD.

关 键 词：肺疾病 慢性阻塞性 睡眠呼吸暂停 阻塞性 呼吸功能试验 气道阻力 重叠综合征 

分 类 号：R563[医药卫生—呼吸系统]