慢性阻塞性肺疾病与阻塞型睡眠呼吸暂停综合征重叠综合征的临床特征及危险因素

Characteristics and risk factors of COPD-OSAHS overlap syndrome

目的观察慢性阻塞性肺疾病(COPD)和阻塞型睡眠呼吸暂停综合征(OSAHS)构成的重叠综合征(OS)患者的临床特征,分析COPD合并OSAHS的危险因素。方法选择2018年10月至2019年12月延安大学附属医院呼吸内科收治的123例COPD患者为研究对象,将患者分为单纯COPD组(n=64)和OS组(n=59)。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别应用t检验或χ^(2)检验进行组间比较。采用Pearson相关系数进行相关性分析。采用多因素logistic回归分析COPD患者合并OSAHS的危险因素。结果OS组呼吸暂停低通气指数(AHI)与颈围、体质量指数(BMI)、动脉二氧化碳分压(PaCO_(2))呈正相关(r=0.774、0.905、0.761,P<0.05);与第一秒用力呼气容积/用力肺活量(FEV 1/FVC)、动脉氧分压(PaO_(2))呈负相关(r=-0.597、-0.856,P<0.05)。颈围(OR=3.453,95%CI 2.004~5.948;P=0.000)、BMI(OR=3.467,95%CI 2.268~6.696;P=0.000)、打鼾(OR=5.925,95%CI 2.622~13.386;P=0.000)、吸烟(OR=2.503,95%CI 1.076~5.822;P=0.033)是COPD合并OSAHS的独立危险因素。结论颈围增大、BMI增大、吸烟及打鼾均是COPD合并OS的危险因素,而OS患者较单纯COPD患者更容易出现低氧和高碳酸血症。

Objective To analyze the risk factors of chronic obstructive pulmonary disease(COPD)and obstructive sleep apnea hypopnea syndrome(OSAHS)by observing the clinical characteristics of patients with COPD-OSAHS overlap syndrome(OS).Methods A total of 123 COPD patients from October 2018 to December 2019 were selected in the Department of Respiratory Diseases of Yan′an University Affiliated Hospital.They were divided into COPD group(n=64)and OS group(n=59).SPSS statistics 22.0 was used for data analysis.According to different data type,t test orχ^(2) test was used for data comparison between two groups.Pearson correlation coefficient and multivariate logistic regression were used to analyze factors of OSAHS in the COPD patients.Results The apnea hypopnea index(AHI)of the OS group was correlated positively with neck circumference,body mass index(BMI),arterial partial pressure of carbon dioxide(PaCO_(2))(r=0.774,0.905,0.761,P<0.05)and negatively with forced expiratory volume in the first second to forced vital capacity(FEV_(1)/FVC),arterial partial pressure of oxygen(PaO_(2))(r=-0.597,-0.856,P<0.05).Neck circumference(OR=3.453,95%CI 2.004-5.948;P=0.000),BMI(OR=3.467,95%CI 2.268-6.696;P=0.000),snoring(OR=5.925,95%CI 2.622-13.386;P=0.000),and smoking(OR=2.503,95%CI 1.076-5.822;P=0.033)were independent risk factors of COPD-OSAHS overlap syndrome.Conclusion Increased neck circumference and BMI,smoking,and snoring are risk factors of COPD-OSAHS overlap syndrome,and patients with overlap syndrome are more likely to have hypoxia and hypercapnia than COPD patients.