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低通气综合征(OSAHS)的中医证型以及危险因素,为COPD合并OSAHS的临床诊治提供参考。方法纳入2020年3月至2022年7月同济大学附属东方医院胶州医院收治的COPD患者107例的,根据是否合并OSAHS分为合并组(63例)与COPD组(44例)。比较两组一般资料、中医证型、血气指标及肺功能指标,分析COPD合并OSAHS的危险因素。结果两组性别、年龄,以及合并糖尿病、合并冠心病、有过敏史者差异无统计学意义(P>0.05);合并组合并高血压、有吸烟史者占比及BMI高于COPD组(P<0.05)。合并组肺脾气虚证占比高于COPD组(P<0.05)。两组pH比较,差异无统计学意义(P>0.05);合并组PaO_(2)、SaO_(2)均低于COPD组,PaCO_(2)高于COPD组(P<0.05)。两组FVC、FEV1比较,差异无统计学意义(P>0.05);合并组FEV1/FVC低于COPD组(P<0.05)。多因素Logistics回归分析显示,合并高血压、有吸烟史、BMI>25 kg/m^(2)、中医证型为肺脾气虚、PaO_(2)≤60 mmHg、PaCO_(2)>45 mmHg为COPD合并OSAHS的危险因素。结论合并OSAHS和COPD患者较单纯COPD患者肺功能受损更严重,更易发生低氧血症及高碳酸血症,合并高血压、有吸烟史、BMI>25 kg/m^(2)、中医证型为肺脾气虚、PaO_(2)≤60 mmHg、PaCO_(2)>45 mmHg为COPD合并OSAHS的危险因素,临床应注意对这些因素的监测和干预,以提高COPD患者疾病防控水平,减轻其肺功能损害。
Objective To analyze the TCM syndromes and risk factors of chronic obstructive pulmonary disease(COPD)complicated with obstructive sleep apnea hypopnea syndrome(OSAHS),and to provide reference for the clinical diagnosis and treatment of COPD complicated with OSAHS.Methods A total of 107 patients with COPD admitted to Jiaozhou Hospital,East Hospital Affiliated to Tongji University from March 2020 to July 2022 were included and divided into combined group(63 cases)and COPD group(44 cases)according to whether OSAHS was combined.The general data,TCM syndromes,blood gas indexes and lung function indexes of the two groups were compared,and the risk factors of COPD combined with OSAHS were analyzed.Results The two groups were compared in terms of gender,age,and the proportions of patients with combined diabetes,combined coronary heart disease,and a history of allergies,with no statistical significance observed(P>0.05);the proportion of patients with hypertension,smoking history and BMI in COPD group were higher than those in COPD group(P<0.05).The proportion of lung,spleen and qi deficiency syndrome in combined group was higher than that in COPD group(P<0.05).There was no statistical significance in the comparison of pH between the two groups(P>0.05);however,the combined group had lower PaO_(2) and SaO_(2) and higher PaCO_(2) compared to the COPD group(P<0.05).Comparison of FVC and FEV1 between the two groups showed no statistical significance(P>0.05);nevertheless,the combined group had a lower FEV1/FVC ratio compared to the COPD group(P<0.05).Multivariate Logistics regression analysis showed that age,combined hypertension,history of smoking BMI>25 kg/m^(2),Chinese medicine evidence of lung,spleen and qi deficiency,PaO_(2)≤60 mmHg,and PaCO_(2)>45 mmHg as risk factors for COPD combined with OSAHS.Conclusions Patients with OSAHS and COPD have more severe lung function damage than patients with COPD alone,and are more likely to have hypoxemia and hypercapnia.Comorbid hypertension,history of smoking,BMI>25 kg/m^(2),Chinese medicine evidence of lung,spleen and qi deficiency,PaO_(2)≤60 mmHg,PaCO_(2)>45 mmHg are risk factors for COPD combined with OSAHS.Clinical attention should be paid to the monitoring and intervention of these factors to improve the level of disease prevention and control in COPD patients and reduce their lung function damage.
作者
王日光
宋润祺
WANG Riguang;SONG Runqi(Department of Traditional Chinese Medicine,Jiaozhou Hospital,East Hospital Affiliated to Tongji University,Qingdao 266300,China)
出处
《中国医药指南》
2024年第21期115-118,共4页
Guide of China Medicine
