青海地区阻塞性睡眠呼吸暂停低通气综合征与外周气道阻力的相关性

Correlation between obstructive sleep hypopnea syndrome and peripheral airway resistance in Qinghai Province

目的通过分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的肺功能,探讨OSAHS与气道外周阻力的相关性。方法收集2017年8月至2019年8月我院住院并确诊为OSAHS的青海地区成年患者184例。根据睡眠呼吸暂停/低通气指数(AHI)将OSAHS患者分为三组,即轻度组(5≤AHI≤15)、中度组(15<AHI≤30)及重度组(AHI>30)。通过Spearman相关性分析探索AHI与R5-R20之间的相关性。多因素线性回归模型用于分析OSAHS不同严重程度与R5-R20之间的关系;根据慢性阻塞性肺疾病(COPD)及性别进行亚组分析,进一步探索OSAHS不同严重程度与R5-R20之间的关系。结果共纳入184例确诊为的青海地区成年患者。Spearman相关性分析结果显示,随着AHI的增加,OSAHS患者的R5-R20随之增加(r=0.402,P<0.001)。多因素线性回归分析得出,OSAHS严重程度每增加一个度,R5-R20增加(β,0.340;95%CI,0.199~0.481;P<0.001)。亚组分析结果显示,无论女性还是男性(女性:β,0.517;95%CI,0.207~0.827;P=0.002;男性:β,0.309;95%CI,0.144~0.474;P<0.001),COPD或非COPD的亚组内(非COPD:β,0.262;95%CI,0.113~0.410;P=0.001;COPD组:β,0.497;95%CI,0.154~0.840;P=0.005),OSAHS严重程度与R5-R20的上述关系仍然存在。结论OSAHS不同严重程度与外周气道阻力相关,即OSAHS越严重,外周气道阻力越大。

Objective According to the lung function of patients with OSAHS,the correlation between OSAHS and peripheral airway resistance was explored.Methods This was a cross-sectional study conducted in respiratory department of affiliated hospital of Qinghai university from August 2017 to August 2019.Adult patients who lived in Qinghai Province,were diagnosed with OSAHS were enrolled.According to apne-hypopnea index(AHI),patients were divided into three groups:mild group(5≤AHI≤15),moderate group(15<AHI≤30),and severe group(AHI>30).Spearman correlation analysis was used to explore the correlation between AHI and R5-R20.The multivariable linear regression models were used to study the relationship between severity of OSAHS and R5-R20.In addition,subgroup analyses were conducted based on sex and chronic obstructive pulmonary disease(COPD)to further explore the relationship between severity of OSAHS and R5-R20.Results A total of 184 adult patients diagnosed with OSAHS were included in this study.Spearman correlation analysis showed that the R5-R20 increased with the elevation of AHI(r=0.402,P<0.001).Multivariable linear regression analysis showed that every degree of OSAHS severity increased,R5-R20 increased(β,0.340,95%CI,0.199-0.481,P<0.001).After that,the results of subgroup analysis showed that the relationship between OSAHS severity and R5-R20 still exists in females and males(females:β,0.517;95%CI,0.207-0.827,P=0.002;Male:β,0.309;95%CI,0.144-0.474,P<0.001),or in non-COPD group and COPD group(non-COPD:β,0.262,95%CI,0.113-0.410,P=0.001;COPD:β,0.497,95%CI,0.154-0.840,P=0.005).Conclusion Severity of OSAHS is related to peripheral airway resistance.Patients in higher degree of OSAHS severity had higher peripheral airway resistance and the risk of the prevalence of chronic bronchitis.