慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征患者的肺功能及睡眠监测分析

Analysis of pulmonary function and sleep structure in chronic obstructive pulmonary disease and overlap syndrome

目的:探讨慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征(亦称重叠综合征,OS)与单纯COPD患者肺功能和睡眠结构的差异。方法:对32例COPD、28例重叠综合征患者分别进行多导睡眠图监测及肺功能测定,并对各组数据作统计学检验。结果:重叠综合征的第一秒用力呼气容积占预计值百分比(FEV1)、第一秒用力呼气容积占用力肺活量百分比(FEV1/FVC)、最大通气量(MVV)均显著低于COPD组(P<0.01,P<0.05);同时重叠综合征组的呼吸暂停低通气指数(AHI)、最长呼吸暂停时间(LAT)和浅睡眠所占百分率(S1+2)显著高于COPD组,而最低脉氧饱和度(LSaO2)、平均脉氧饱和度(MSaO2)、深睡眠所占百分率(S3+4)显著低于COPD组(P<0.01,P<0.05)。结论:重叠综合征患者睡眠结构显著改变,夜间缺氧及肺功能受损更严重。

Objective To investigate the characteristics of lung function and changes of sleeping in patients with chronic obstructive pulmonary disease（ COPD）and overlap syndrome（ OS）. Methods Thirty- two patients with COPD and twenty-eight patients with OS were selected for collecting polysomnography（ PSG）and lung functions data. The analysis of the data from each group was assessed by t test. Results Forced expiratory volume in one second（ FEV1 ）,the percentage of FEV1 than forced vital capacit（ FEV1/FVC）,maximal vol-untary ventilation（MVV）in OS group were significantly lower than that of in COPD group（P〈0. 01,P〈0. 05）. Moreover with in OS group,apnea hypopnea index（ AHI）,the longest apnea time（ LAT）,and the percentage of light sleep（ S1＋2 ）were significantly increased, but the lowest oxygen saturation（ LSaO2 ）,mean oxygen saturation（ MSaO2 ）,and the percentage of deep sleep（ S3＋4 ）were significantly low-er when compared with COPD groups（P〈0. 01,P〈0. 05）. Conclusion Patients with OS have severe night time hypoxemia concomitant significant changes in sleeping characteristics and obstructive ventilator function.