摘要
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)的临床特点及危险因素。方法回顾性分析本院在2019年10月-2020年10月收治的216例慢阻肺患者的临床资料,根据多导睡眠监测(PSG)结果将其分为单纯慢阻肺组[呼吸暂停低通气指数(AHI)≤15次/h,n=140]和合并OSA组(AHI>15次/h,n=76),观察单纯慢阻肺组和合并OSA组患者的临床特点,对慢阻肺合并OSA的危险因素进行单因素logistic回归分析和多因素logistic回归分析,同时分析慢阻肺气流受限程度与OSA严重程度的相关性。结果单纯慢阻肺组在性别方面、合并疾病方面以及mMRC评分方面和合并OSA组患者比较无统计学意义(P>0.05)。同时单纯慢阻肺组年龄明显低于合并OSA组,体重指数明显低于合并OSA组,病程明显长于合并OSA组,FEV_(1)明显低于合并OSA组,FEV_(1)/FVC明显低于合并OSA组,FEV_(1)占预计值%<50%占比明显高于合并OSA组,CAT评分明显低于合并OSA组,SACS评分明显低于合并OSA组,CCI评分明显低于合并OSA组,吸烟指数明显低于合并OSA组,颈围明显低于合并OSA组,ESS评分明显低于合并OSA组,AHI明显低于合并OSA组,差异均有统计学意义(P<0.05)。单因素logistic回归分析结果显示体重指数、FEV_(1)占预计值%<50%、CAT评分、SACS评分、颈围以及ESS评分是慢阻肺合并OSA的危险因素(P<0.05)。多因素logistic回归分析结果显示体重指数、FEV_(1)占预计值%<50%、CAT评分、SACS评分以及ESS评分是慢阻肺合并OSA的独立危险因素(P<0.05),轻度慢阻肺和中度慢阻肺患者在合并OSA风险方面要比重度慢阻肺患者更高(P<0.05)。结论慢阻肺合并OSA患者临床特点为日间嗜睡以及日常活动受限更明显,其中体重指数、FEV_(1)占预计值%<50%、CAT评分、SACS评分以及ESS评分是慢阻肺合并OSA的独立危险因素,在合并OSA风险方面,相较于轻中度慢阻肺患者,重度慢阻肺患者风险更低。
Objective To analyze the clinical features and risk factors of COPD combined with obstructive sleep apnea(OSA).Methods The clinical data of 216 patients with COPD admitted to our hospital from October 2019 to October 2020 were retrospectively analyzed,and according to the results of polysomnography(PSG),all cases were divided into simple COPD group[apnea hypopnea Index(AHI)≤15 times/h,n=140]and combined OSA group(AHI>15 times/h,n=76).The clinical characteristics of two groups were observed.Univariate logistic regression analysis and multivariate logistic regression analysis were performed on the risk factors of pulmnonary complicated with OSA.Results There were no significant differences in gender,comorbidities and mMRC score between the COPD group alone and the patients with OSA(P>0.05).At the same time,the age of the simple COPD group was significantly lower than that of the combined OSA group,the body mass index was significantly lower than that of the combined OSA group,and the course of disease was significantly longer than that of the combined OSA group.FEV_(1)was significantly lower than that of the combined OSA group.FEV_(1)/FVC was significantly lower than that of the combined OSA group.FEV_(1)accounted for the predicted value%<50%was significantly higher than the combined OSA group,the CAT score was significantly lower than that of the combined OSA group,the SACS score was significantly lower than the combined OSA group,the CCI score was significantly lower than that of the combined OSA group,and the smoking index is significantly lower than that of the combined OSA group,The neck circumference was significantly lower than that of the combined OSA group,the ESS score was significantly lower than that of the combined OSA group,and the AHI was significantly lowr than that of the combined OSA group.The differences were statistically significant(P<0.05).Univariate logistic regression analysis showed that body mass index,FEV_(1)accounted for%<50%of predicted value,CAT score,SACS score,neck circumference and ESS score were risk factors for COPD complicated with OSA(P<0.05).Multivariate logistic regression analysis showed that body mass index,FEV_(1)accounted for%<50%of predicted value,CAT score,SACS score and ESS score were independent risk factors for COPD complicated with OSA(P<0.05).Conclusion The clinical features of patients with COPD combined with OSA are more obvious daytime sleepiness and limitation daily activities.Among them,body mass index,FEV_(1)accounts for the predicted value less than 50%,CAT score,SACS score and ESS score are independent risks of COPD combined with OSA.In terms of the risk of combined OSA,patients with severe COPD have a lower risk than patients with mild to moderate COPD.
作者
周建盈
张东瑜
张志军
ZHOU Jianying;ZHANG Dongyu;ZHANG Zhijun(Department of Respiratory Medicine,People's Hospital of Xuwen County,Zhanjiang,Guangdong,524000,China;Department of Endocrinology,Central People's Hospital of Zhanjiang city,Zhanjiang,Guangdong,524100,China)
出处
《新疆医学》
2022年第6期662-665,共4页
Xinjiang Medical Journal
