高原夜间血氧饱和度监测重叠综合征患者的临床价值

Clinical value of nocturnal SaO_2 mornitoring in patients with overlap syndrome at high altitude

目的研究高原慢性阻塞性肺疾病（COPD）患者夜间动态血氧饱和度（SaO2）变化，评价不同SaO2指标对病情严重程度的临床价值及意义。方法用多导睡眠记录仪对单纯COPD组13例患者、重叠综合征12例患者进行夜间睡眠、呼吸及动态SaO2同步连续监测。结果COPD组的呼吸紊乱指数（AHI）为3．7±1．3，重叠综合征组为35．7±12．9，两组差异有显著性（P＜0．001）；两组患者的最低SaO2（ISaO2）、平均SaO2（MSaO2）、氧饱和度≤85％的时间占总监测时间的百分比（SIT85）、氧减饱和度指数（DI4）等措标比较，差异均有显著性（P＜0．001），清醒时SaO2（HSaO2）的两组间差异无显著性（P＞0．05）、AHI与DI4直线相关（系数0．71，P＜0．05），二者相关性较好。结论选用适当的DI4作指标，对初步筛选和准确判断COPD患者中的SAS具有重要的临床价值。

Objective To study the nocturnal dynamic change of SaO2 in patients with overlap syndrome at high altitude, and to evaluate the value and significance of oxygen desaturation in assessing disease severity by means of polyaomnography. Methods 13 patients with COPD and 12 with overlap sydrome were conducted noctural sleep, respiratory and dynamic SaO2 mornitioring. Results AHIs in the both groups were 3.7±1.3 and 35.7±12.9 respectively, and there was a significant difference between these two groups (P<0.001). There were significant difference between these two groups in LSaO2, HSaO2, SIT85 and DI4 (P<0.0005~0.0001). There was a liner correlation between AHI and DI4. Conclusions In Patients with COPD, a suitable oxygen desaturation index has important clinical value on the preliminary selection adn accurate diagnosis of SAS.