摘要
目的探讨慢性阻塞性肺疾病(简称慢阻肺)合并阻塞性呼吸睡眠暂停(obstructive sleep apnea,OSA)危险因素及与呼吸暂停低通气指数(apnea-hypopnea index,AHI)的相关性。方法回顾性分析我院2016年1月—2019年12月收治慢阻肺患者共216例临床资料,根据有无伴OSA分组;比较伴和未伴OSA组临床特征资料,采用多因素法分析慢阻肺合并OSA发病影响因素,同时评价AHI与慢阻肺合并OSA可能影响因素相关性。结果①伴OSA组年龄、体重指数(body mass index,BMI)、颈围、吸烟指数、第1秒用力呼气容积(forced expiratory volume in 1 second,FEV_(1))、FEV_(1)占预计值百分比(FEV_(1)%pred)、FEV_(1)与用力肺活量(forced vital capacity,FVC)比值(FEV_(1)/FVC)、慢阻肺评估测试(COPD assessment test,CAT)评分、Epworth嗜睡量表(Epworth sleepiness scale,ESS)评分、Charlson合并症指数(Charlson comorbidity index,CCI)评分、睡眠呼吸暂停临床评分(sleep apnea clinical score,SACS)评分及伴原发性高血压比例均显著多于未伴OSA组(P<0.05);伴OSA组病程、重度慢阻肺及GOLD 4级比例均显著少于未伴OSA组(P<0.05);②AHI与患者年龄、BMI、颈围、吸烟指数、FEV_(1)%pred、FEV_(1)%pred<50%比例、CAT评分、ESS评分、CCI评分及SACS评分呈正相关(P<0.05);与FEV_(1)%pred<50%比例呈负相关(P<0.05);③多因素分析结果证实,BMI、FEV_(1)%pred<50%比例、CAT评分及ESS评分均是慢阻肺合并OSA发病独立影响因素(P<0.05);④GOLD分级4级AHI<5次/h比例显著高于1~3级(P<0.05),GOLD分级4级AHI>30次/h比例显著低于1~3级(P<0.05)。结论慢阻肺合并OSA发病与BMI、FEV_(1)%pred、CAT评分及ESS评分独立相关,其中重度慢阻肺患者伴OSA风险更低。
Objective To investigate the risk factors of chronic obstructive pulmonary disease(COPD)combined with obstructive sleep apnea(OSA)and its relationship with apnea-hypopnea index(AHI).Methods Clinical data of 216 COPD patients with OSA were retrospectively chosen in the period from January 2016 to December 2019 in our hospital.All patients were divided into different groups according to with or without OS A and the clinical features of patients with and without OSA were compared.Multivariate analysis was used to analyze the influencing factors of COPD with OSA and the correlation between AHI and COPD with OSA was also evaluated.Results①The age,body mass index(BMI),neck circumference,smoking index,forced expiratory volume in 1 second(FEV_(1)),FEV_(1)%predicted(FEV_(1)pred),the ratio of FEV_(1)to the forced vital capacity of the lungs(FEV_(1)/FVC),COPD assessment test(CAT)score,Epworth sleepiness scale(ESS)score,Charlson comorbidity index(CCI)score,sleep apnea clinical score(SACS)score and proportion of patients with essential hypertension in OSA group were significantly higher than non-OSA group(P<0.05).The course of disease and the proportion of severe COPD and GOLD grade 4 in OSA group were significantly less than non-OSA group(P<0.05).②AHI was positively correlated with age,BMI,neck circumference,smoking index,FEV_(1)%pred,FEV_(1)%pred<50%,CAT score,ESS score,CCI score and SACS score(P<0.05);and negatively correlated with FEV_(1)%pred<50%(P<0.05).③Multivariate analysis showed that BMI,FEV_(1)%pred<50%,CAT score and ESS score were the independent factors of COPD patients with OSA(P<0.05).④The proportion of AHI<5 times/h in GOLD grade 4 was significantly higher than GOLD grade 1-3(P<0.05).The proportion of AHI>30 times/h in GOLD grade 4 was significantly lower than GOLD grade 1-3(P<0.05).Conclusion The incidence of COPD with OS A was independently correlated with BMI,FEV_(1)%pred,CAT score and ESS score;patients with severe COPD possess lower OSA risk.
作者
胡艳艳
王伟
潘慧娴
李晓君
白晓敏
HU Yanyan;WANG Wei;PAN Huixian;LI Xiaojun;BAI Xiaomin(Department of Respiratory and Respiratory Critical Care,The First Hospital of Handan,Handan,Hebei 056000,P.R China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2022年第6期391-395,共5页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
慢性阻塞性肺疾病
阻塞性呼吸睡眠暂停
特征
影响因素
Chronic obstructive pulmonary disease
obstructive sleep apnea
characteristics
influencing factors
