慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停对患者合并症的影响和管理  

Impact and management of comorbidities in patients with chronic obstructive pulmonary disease and obstructive sleep apnea

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作  者:孙婉璐 陈亚红[2] Sun Wanlu;Chen Yahong(Department of Respiratory and Critical Care Medicine,Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Department of Respiratory and Critical Care Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区:[1]首都医科大学附属北京朝阳医院、北京市呼吸疾病研究所、呼吸与危重症医学科,北京100020 [2]北京大学第三医院呼吸与危重症医学科,北京100191

出  处:《中华结核和呼吸杂志》2025年第4期392-395,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

基  金:国家自然科学基金重大项目课题(82090014);首都卫生发展科研专项项目(首发2020-2Z-40917);院队列建设项目(BYSYDL2021013)。

摘  要:慢性阻塞性肺疾病(简称慢阻肺病)和阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)均为呼吸系统常见病,且常合并存在。慢阻肺病合并OSA(overlap syndrome,OS)可导致严重的低氧血症和高碳酸血症、睡眠质量下降,增加心律失常、肺动脉高压、右心衰竭等合并症风险,最终导致高住院率和病死率。目前临床实践中常倾向于一元论,对OS的危害认识不足,需要更加积极地筛查和诊断、密切关注和纠正OS患者的夜间低氧。无创呼吸机治疗是OS最重要的治疗方案,应进一步关注日间-夜间、稳定期-急性加重期的病情差异,将无创通气治疗精确化、规范化,积极预防和管理相关合并症,改善OS的预后。Chronic obstructive pulmonary disease(COPD)and obstructive sleep apnea(OSA)are both common respiratory system disorders that often coexist.The combination of COPD and OSA,known as overlap syndrome(OS),can lead to severe hypoxemia,hypercapnia,poor sleep quality,and increased risks of arrhythmias,pulmonary hypertension,right heart failure,and other complications.This ultimately results in high rates of hospitalization and mortality.Currently,clinical practice tends to be reductionist,with insufficient awareness of the dangers posed by OS.There is a need for more proactive screening,diagnosis,and close monitoring and correction of nocturnal hypoxia in OS patients.Non-invasive ventilation is the most important treatment for OS.It is crucial to further address the differences in patient conditions during the day and night,as well as between stable and acute exacerbation phases,to refine and standardize non-invasive ventilation therapy.Additionally,actively preventing and managing related complications will help improve the prognosis of OS.

关 键 词:低氧血症 高碳酸血症 阻塞性睡眠呼吸暂停 overlap综合征 

分 类 号:R563.9[医药卫生—呼吸系统]

 

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