老年COPD患者并发阻塞性睡眠呼吸暂停低通气综合征的危险因素分析

Analysis on the risk factors of complicated obstructive sleep apnea hypopnea syndrome in elderly patients with COPD

目的观察老年慢性阻塞性肺疾病(COPD)患者并发阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的相关危险因素。方法选取2019年1月~2020年6月我院呼吸科住院的60例COPD患者作为研究对象,根据肺功能指标及呼吸暂停低通气指数(AHI)将患者分为单纯COPD组(n=27)与COPD并发OSAHS组(n=33),比较患者的肺功能分级、BMI、颈围、吸烟指数、6 min步行实验测试、COPD评估测试(CAT)评分、Epworth嗜睡量表测试(ESS)、肺功能、多导睡眠监测(PSG),对COPD并发OSAHS的危险因素进行Logistic相关性分析。结果COPD并发OSAHS组患者BMI、吸烟指数、AHI、CAT、ESS均高于单纯COPD组,FEV1、6 min步行试验低于单纯COPD组,差异有统计学意义(P<0.05);经过多因素分析显示,老年COPD患者并发OSAHS与患者BMI、吸烟指数及FEV1有关(P<0.05)。结论老年COPD患者并发OSAHS发生率高,且BMI、吸烟指数越高,肺功能越差,并发OSAHS风险越高,应予以高度关注。

Objective To observe the related risk factors of complicated obstructive sleep apnea hypopnea syndrome(OSAHS)in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 60 patients with COPD admitted to the department of respiratory of our hospital from January 2019 to June 2020 were selected as the research objects.According to pulmonary function indexes and apnea hypopnea index(AHI),the patients were divided into the single COPD group(n=27)and the COPD complicated with OSAHS group(n=33).The pulmonary function classification,BMI,neck circumference,smoking index,6-minute walking test,COPD assessment test(CAT)score,Epworth sleepiness scale test(ESS),pulmonary function and polysomnography(PSG)were compared.Meanwhile,the logistic correlation analysis was made on the risk factors of COPD complicated with OSAHS.Results BMI,smoking index,AHI,CAT and ESS of patients in the COPD complicated with OSAHS group were all higher than those of patients in the single COPD group,while FEV1 and 6-minute walking test were lower than those of patients in the single COPD group,with statistically significant differences(P<0.05).Multivariate analysis showed that OSAHS in elderly COPD patients was associated with BMI,smoking index and FEV1 of patients(P<0.05).Conclusion Elderly patients with COPD complicated with OSAHS have a high incidence,and the higher BMI and smoking index,the worse pulmonary function and the higher risk of OSAHS complication,which should be paid close attention to.