慢性阻塞性肺疾病和OSAHS重叠综合症27例临床分析

Clinical analysis of 27 patients with chronic obstructive pulmonary disease and obstructive sleep apnea hypopneasyndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征对慢性阻塞性肺疾病患者的影响。方法分析82例慢性阻塞性肺疾病患者和27例重叠综合征(慢性阻塞性肺疾病及阻塞性睡眠呼吸暂停低通气综合征重叠)患者的临床资料,比较其1秒钟用力呼气量,多导睡眠图监测中最低血氧饱和度,血氧饱和度低于90%占监测总时间的百分比,日间最低血氧饱和度,发生Ⅱ呼吸衰竭的例数,合并肝肾功能异常、高血压、糖尿病或心脑血管病得例数,死亡率。结果重叠综合征患者的日间、夜间最低血氧饱和度、血氧饱和度低于90%占监测总时间的百分比、发生Ⅱ呼吸衰竭的比例,并发肝肾功能异常、高血压、糖尿病或心脑血管病的比例及死亡率均显著高于慢性阻塞性肺疾病患者(P<0.05)。结论及时发现慢性阻塞性肺疾病患者中是否合并阻塞性睡眠呼吸暂停低通气综合征的存在非常重要。

Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome on patients with chronic pulmonary disease. Methods The clinical records of 82 patients with chronic pulmonary disease and 27 patients with overlap syndrome were retrospectively analyzed, which included the labored respiratory capacities per second, the lowest degrees of blood oxygen saturation in polysomnogram monitoring, the percentages of time how long the degree blood oxygen saturation lower than 90% in the whole monitoring, the lowest degrees of blood oxygen saturation in daytime, the number of cases attacked by type 2 respiratory failure, abnormal liver-kidney function, hypertension, diabetes, cardiovascular-cerebrovascular disease and the mortality. Results The lowest degrees of blood oxygen saturation in daytime or at night, the percentages of the time how long the degree blood oxygen saturation lower than 90% in the whole monitoring, the number of cases attacked by type 2 respiratory failure, abnormal liver-kidney function, hypertension, diabetes, cardiovascular-cerebrovascular disease and the mortality of the patients with overlap syndrome were all significantly higher than those of the patients with chronic pulmonary disease （P〈0.05）. Conclusion It is very important to find out whether patients with chronic pulmonary disease or obstructive sleep apnea hypopnea syndrome in time.