阻塞性睡眠呼吸暂停低通气综合征与合并慢性阻塞性肺疾病患者的日间高碳酸血症的临床研究

Daytime hypercapnia in patients with pure obstructive sleep apnea-hypopnea syndrome and overlap syndrome

目的比较单纯阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hypopnea syndrome,OSAHS）与合并慢性阻塞性肺疾病即重叠综合征（overlap syndrome, OS） 患者肺功能变化，日间高碳酸血症与睡眠呼吸紊乱之间的关系。方法42例OSAHS患者，23例为单纯OSAHS患者组，19例为OS患者组．两组均做多导睡眠仪监测、肺功能检测、血气分析检测。比较两组睡眠紊乱指标、肺功能及PaCO2情况并做相关性分析。结果两组患者在睡眠呼吸暂停低通气指数相似的情况下，OS组的PaCO2明显高于OSAHS组；OS组的肺功能指标明显差于OSAHS组；两组患者的日间PaCO2与睡眠呼吸暂停严重程度之间无明显线性相关关系。结论OS组患者的肺功能较0SAHS组差；OS组的日间高PaCO2与是否合并OSAHS无关。

Objective To investigate the relations between pulmonary function, hypercapnia and nocturnal respiratory disorders in the patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） and overlap syndrome （OS）. Methods Forty-two subjects who were diagnosed as OSAHS by polysomnography were studied. Their pulmonary functions and blood gas analysis in the daytime were measured. The subjects were divided into two groups in relation to the presence of pure OSAHS patients and OS patients. Comparisions were made in pulmonary function, AHI and PaCO2 between 23 OSAHS patients and 19 OS patients. Results There was no difference in terms of AHI between two groups, but pulmonary functions and PaCO2 were significantly different. The patients with OS experienced worse pulmonary functions and higher PaCO2 than OSAHS patients. AHI and LSaO2 of OSAHS patients and OS patients are unrelated to daytime hypercapnia. Conclusions Pulmonary functions are more severe in OS patients than OSAILS patients. Daytime hypercapnia in COPD patients is unrelated to in the patients with OSAHS or not.