COPD合并OSAHS重叠综合征患者临床特征研究  

Clinical Chraracteristics of OSAHS-COPD Overlap Syndrome Patients

作　　者：奚峰[1] 陈蕊华[2] 蒋晓真[2] 顾文超[1] 杨华[1] 吴浩[1] 王林宣 刘锦铭[3] Xi Feng Chen Ruihua Jiang Xiaozhen Gu Wenchao Yang Hua Wu Hao Wang Linxuan Liu Jinming(Department of Respiratory Medicine Department of Endocrinology, Shanghai Pudong New Area People＇s Hospital, Shanghai, 201299 Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Shanghai, 200433, P. R. China)

机构地区：[1]上海市浦东新区人民医院呼吸内科,上海201299 [2]上海市浦东新区人民医院内分泌科,上海201299 [3]上海市肺科医院肺循环科,上海200433

出　　处：《老年医学与保健》2017年第3期203-205,共3页Geriatrics & Health Care

基　　金：上海市浦东新区卫生和计划生育委员会科技项目(PW2012A-21);上海市浦东新区科技发展基金创新基金项目(PKJ2013-Y28);上海市浦东新区卫生系统重点学科建设基金(PWZX2014-12)

摘　　要：目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并慢性阻塞性肺疾病(COPD)重叠综合征(OS)患者临床特征,为其诊断及并发症的研究提供参考。方法选择2012年7月—2014年12月收治的OSAHS、COPD和OS患者各30例,同时设立健康对照组30例。检测并比较各组缶床资料、多导睡眠监测、肺功能、心超、和肺动脉收缩压(sPAP)情况。结果 4组中OS组的氧分压(PaO_2)、夜间最低氧饱和度(LSaO_2)和一秒用力呼气容积(FEV1%)最低,sPAP最高(P<0.05)。OSAHS与COPD对sPAP有正交互作用(F=5.88,P=0.02)。OS组的sPAP分别与腰围和AHI呈正相关(r=0.22和r=0.21,均P<0.05),而与FEV1/FVC和SaO_2呈负相关(/r=-0.48,P<0.01;r=-0.23,P<0.05)。结论 OS患者的低氧和肺动脉高压程度较重,患者的肺动脉压与向心性肥胖、夜间呼吸暂停和肺功能均有高度相关性。Objective To observe the clinical characteristics of OSAHS-COPD overlap syndrome（OS） patients so as to provide reference for the diagnosis and the study of complication occurrence.Methods 4 groups were enrolled in the study,including 30 patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）,30 with chronic obstructive pulmonary disease（COPD）,30 with OS,who were hospitalized during the period from July,2012 to Dec.,2014,and 30 norm as the control;polysomnography（PSG）,cardiac ultrasound,detection of pulmonary function and pulmonary artery systolic pressure（sPAP） were made to the cases in the 4 groups and the data of each group were comparatively studied.Results The oxygen pressure（PaO2）,lowest nocturnal oxygen saturation（LSaO2） and forced expiratory volume in l second（FEV1%） in OS group were the lowest and those in sPAP group were the highest among the 4 groups（P〈0.05）;OSAHS and COPD were in positive interaction with sPAP（F=5.88,P=0.02）;sPAP in OS group was in positive correlation to waist circumference（r=0.22,P=0.04） and AHI（r=0.21,P=0.04） while in negative correlation to FEV1/FVC（r=-0.48,P〈0.01） and SaO2（r=-0.23,P=0.04）.Conclusions Hypoxia and pulmonary arterial hypertension in OS patients are more severe,and the pulmonary artery pressure is highly correlated to central obesity,nocturnal apnea and pulmonary function

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 慢性阻塞性肺病 重叠综合征 肺动脉高压 

分 类 号：R563.9[医药卫生—呼吸系统] R766[医药卫生—内科学]