云南昆明地区阻塞性睡眠呼吸暂停低通气综合征患者的慢性阻塞性肺疾病流行状况

摘要

目的 了解云南昆明地区阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的慢性阻塞性肺疾病(COPD)的患病情况及重叠综合征(OS)的临床表现.方法 回顾性研究4 636例打鼾患者,排除COPD以外慢性呼吸系统疾病,并对患者进行病情评估.测试内容包括AHI(呼吸暂停低通气指数)、BMI(体质量指数)、Epworth嗜睡量表测试和肺功能等.OS确诊的指标是同时满足AHI>5次/h并且FEV1/FVC<70%.结果 2006-2012年,云南昆明地区OSAHS患者合并COPD的患病率为10.1%(95% CI 9.1%~11.1%),而且男性OS患病率高于女性,男性为10.2%,女性为9.7%.OS患者平均年龄为(56.9±14.1)岁,平均AHI为(47.46±26.79)次/h,平均FEV1/FVC为(60.09±23.57)%.多导睡眠监测结果 提示,单纯OSASH组和OS组患者夜间存在明显的低氧血症,但是OS组患者更为显著.肺功能检测结果 提示,OS患者慢性阻塞性肺疾病病情更严重.结论 OSAHS患者合并COPD在云南昆明地区患病率较高,并且高年龄段患病率达到24%以上.同时OS患者较单纯OSAHS和COPD患者在肺功能和低氧血症病情表现更严重,但是其发病机制尚不能确定.%Objective To know the prevalence of chronic obstructive pulmonary disease(COPD) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) in Kunming Yunnan Province, and the clinical symptom of OS.Methods Retrospective study of 4 636 cases of patients with snoring, excluding COPD in addition to chronic respiratory disease and assess the patient`s condition.The test included AHI, BMI, Epworth sleepiness scale, lung function.The index of OS was confirmed by AHI>5 times/h and FEV1/FVC<70%.Results During the period of 2006 to 2012, he prevalence of COPD in patients with OSAHS was 10.1% [95% confidence interval (CI) 9.1%-11.1%] in Kunming Yunnan Province.And male`s OS prevalence rate is higher than the female(male 10.2%;female 9.7%).The OS patients` average age was 56.9±14.1, the mean AHI was (47.46±26.79) times/h, and the average FEV1/FVC was 60.09%±23.57%.Polysomnographyresults show that patients suffered obvious hypoxiaat night in both OSAHS group and OS group, but it was more significant in OS group.Pulmonary function test showed that OS patients have more serious chronic obstructive pulmonary disease.Conclusions The prevalence of COPD in OSAHS patients was high in Kunming, Yunnan Province, and the prevalence rate in old group reached more than 24%.In addition, the sympotms of patients with OS were more severe than those with only OSAHS or COPD in lung function and hyoxemia.