慢阻肺合并OSAS患者呼吸衰竭的危险因素分析

Analysis of risk factors of respiratory failure in COPD patients complicated with OSAS

目的发现慢性阻塞性肺疾病(慢阻肺)合并OSAS患者的流行病学资料与病情资料中促进其发生呼吸衰竭的危险因素。方法收集2012年12月至2014年12月期间入院的OS慢阻肺合并OSAS患者的流行病学资料与病情资料。利用单因素分析和Logistic多因素分析筛选慢阻肺合并OSAS患者发生呼吸衰竭的危险因素,P<0.05。应用SPSS统计学方法。结果单因素分析显示:年龄、性别、BMI指数、吸烟史及是否合并心脑血管疾病、咳嗽、咳痰、发热、AHI、LSaO_2、Ts90%、FEV1占预计值百分比、FEV1/FVC在呼吸衰竭组和非呼吸衰竭组之间的差异均无统计学意义(P>0.05)。而颈围、呼吸困难和/或发绀、夜间憋醒、LAT、m SaO_2在呼吸衰竭组和非呼吸衰竭组之间的差异则具有统计学意义(P<0.05)。logisitc多因素分析显示:颈围(OR=1.75)、呼吸困难/发绀(OR=20.01)为OS患者发生急性呼吸衰竭的危险因素(P<0.05)。结论OS患者的颈围和呼吸困难/发绀是影响OS患者的重要危险因素。

Objective To evaluate the risk factors of respiratory failure in COPD patients complicated with OSAS. Methods The clinical data of COPD patients complicated with OSAS were collected from December 2012 to December 2014. The single factor analysis and Logistic multivariate analysis was applied to evaluate the risk factors of respiratory failure. While P〈0. 05,the statistics was significant. Results The univariate analysis showed that age,gender,BMI,smoking history and whether the merger of cardiovascular and cerebrovascular diseases,cough,sputum,fever,AHI,lsaO2,Ts90%,FEV1%,FEV1/ FVC% were un significance（ P〉0. 05）. And neck circumference,dyspnea and / or cyanosis,night hold awake,LAT and m SaO2 were statistical significant in respiratory failure（ P〈0. 05）. Logistic multivariate analysis showed that the neck circumference（ OR = 1. 75）,dyspnea and cyanosis（ OR = 20. 01） were the risk factors of acute respiratory failure（ P〈0. 05）. Conclusion The neck circumference and dyspnea / cyanosis are important risk factors of respiratory failure in COPD patients complicated with OSAS.