慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停的危险因素分析

Risk factors of chronic obstructive pulmonary disease complicated by obstructive sleep apnea

目的分析慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSA)的危险因素。方法抽取2022年5月至2023年5月郑州大学第一附属医院收治的COPD患者90例,按照是否合并OSA分为单纯组(单纯COPD,47例)与合并组(COPD合并OSA,43例)。收集并分析两组临床资料,应用Logistic分析COPD合并OSA的危险因素。结果合并组打鼾史构成比(79.07%,34/43)、吸烟史构成比(76.74%,33/43)高于单纯组(36.17%,17/47;53.19%,25/47),P<0.05;合并组氧分压、血氧饱和度、第1秒用力呼气容积与用力肺活量比值、最低氧饱和度、平均氧饱和度水平低于单纯组(P<0.05);合并组二氧化碳分压、呼吸暂停低通气指数、血氧饱和度<90%占检测时间百分比高于单纯组(P<0.05)。多因素Logistic回归分析结果显示,颈围、体质指数、打鼾、吸烟是COPD合并OSA的独立危险因素(OR=3.46、3.46、5.93、2.50,P均<0.05)。结论相较于COPD患者,合并OSA的COPD患者更易出现高碳酸血症、低氧血症等情况,打鼾、高体质指数、颈围增大及吸烟是COPD合并OSA的独立危险因素。

Objective To analyze the risk factors of chronic obstructive pulmonary disease(COPD)complicated by obstructive sleep apnea(OSA).Methods A total of 90 patients with COPD who were admitted to the First Affiliated Hospital of Zhengzhou University from May 2022 to May 2023 were selected,and the patients were divided into simple group(47 cases,only with COPD)and combined group(43 cases,with COPD complicated by OSA)according to whether they were complicated by OSA.The clinical data of the two groups were collected and analyzed.And logistic analysis was used to analyze the risk factors for COPD complicated by OSA.Results The proportion of patients with snoring history(79.07%,34/43)and smoking history(76.74%,33/43)of the combined group were higher than those of the simple group(36.17%,17/47;53.19%,25/47),P<0.05.The levels of partial pressure of oxygen,blood oxygen saturation,ratio of forced expiratory volume in 1 second to forced vital capacity,minimum oxygen saturation,and mean oxygen saturation of the combined group were lower than those of the simple group(P<0.05).The partial pressure of carbon dioxide,apnea-hypopnea index,and percentage of oxygen saturation<90%time to examination time in the combined group were higher than those in the simple group(P<0.05).Results of multivariate logistic regression analysis showed that neck circumference,body mass index,snoring,and smoking were independent risk factors for COPD complicated by OSA(OR=3.46,3.46,5.93,2.50;all P<0.05).Conclusions Compared with COPD patients,COPD patients with OSA are more prone to developing hypercapnia and hypoxemia.Snoring,high body mass index,increased neck circumference and smoking are independent risk factors for COPD complicated by OSA.