重叠综合征36例临床分析

Clinical analysis of 36 cases of overlapped syndrom

目的提高对重叠综合征(COPD合并OSAS)的临床认识。方法回顾性的分析了36例重叠综合征的临床资料,36例都有慢性阻塞性肺疾病(COPD)的病史,所有患者均进行睡眠检查(澳大利亚产的AutoSet),符合阻塞性睡眠呼吸暂停综合征(OSAS)的诊断标准。结果重叠综合征患者既有COPD的临床表现,又有OSAS的症状和体征,其比单纯OSAS/COPD有更严重的与睡眠有关的低氧,更易引起肺动脉高压及发展成慢性肺心病。结论COPD患者如有OSAS的症状和体征,如打鼾、夜间呼吸暂停及白天嗜睡等临床表现,应及时行睡眠监测。临床上可用无创伤性正压通气治疗改善患者睡眠质量并纠正夜间低氧血症。

Objective To explore and understand the association of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSAS). Methods Thirty-six patients, who were selected solely based on confirmed diagnosis of COPD with OSAS, were prospectively examined. The clinical manifestations and laboratory data of the patients were analyzed with the use of sleep monitor.Results All patients not only had symptoms and signs of COPD but also had that of OSAS. Overlapped syndrom patients had more severe sleep-related hypoxemia than COPD/OSAS patients. These patients were more likely to have pulmonary hypertension or developed chronic cor pulmonale.Conclusion Sleep monitor is indicated in patients with COPD whose illness is complicated by symptoms and signs of OSAS such as snore, sleep apnea and/or daytime hypersomnolence. Noctural noninvasive positive pressure ventilation was recommended for the patients to improve sleep quality and correct sleep-related hypoxemia and hypercapnia.