中年慢性阻塞性肺疾病和支气管哮喘患者中的阻塞性睡眠呼吸暂停与特应性

Obstructive sleep apnoea and atopy among middle aged chronic obstructive pulmonary disease and bronchial asthma patients.

作者信息

Kumar Raj, Nagar Devender, Mallick Adeeb, Kumar Manoj, Tarke Chandrakant R, Goel Nitin

出版信息

J Assoc Physicians India. 2013 Sep;61(9):615-8.

Abstract

BACKGROUND

Obstructive sleep apnoea syndrome is associated with significant morbidity. A high prevalence of obstructive sleep apnoea (OSA) symptoms has been reported in patients with asthma and chronic obstructive pulmonary disease (COPD). There are limited studies regarding relationship between atopy and OSA.

OBJECTIVE

To study the risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients by a home based sleep study and its association with atopy.

METHODS

Patients with asthma and COPD were evaluated for OSA symptoms by Epworth sleepiness scale (ESS) and Berlin questionnaire (BQ). ESS score > or = 9 was considered as high risk for OSA. Patients having high risk for OSA by ESS and BQ were further evaluated for OSA by home based sleep study. Skin prick test against common allergens was done to diagnose atopy in these patients.

RESULTS

Among 400 patients (229, 57.25% male and 171, 42.75% female) 328 were asthmatics and 72 were COPD patients. ESS and BQ was positive in 11.25% (45/400) and 18.25% (73/400) patients respectively. ESS was positive in 10.67% (35/328) of asthma and 13.88% (10/72) of COPD patients. BQ was positive in 18.29% (60/328) of asthmatic and 18.05% (13/72) of COPD patients. Skin prick test was positive in 74.16% patients. The maximum positivity was found in asthmatics (139/155, 89.68%) compared to COPD patients (16/155, 10.32%). Skin prick test was done for 40 patients out of 73 of Asthma and COPD patients who were found positive by ESS and BQ. 72.5% patients were found to be atopic. Out of 19 patients in whom home polysomnography was done, 13 patients consented for skin prick test with common aeroallergens and 9 (69.23%) patients were found to be atopic.

CONCLUSIONS

There is an increased risk of obstructive sleep apnoea among middle aged chronic obstructive pulmonary disease and asthma patients. Atopy could be associated with OSA. The association needs to be proved in a larger study.

摘要

背景

阻塞性睡眠呼吸暂停综合征与严重的发病率相关。哮喘和慢性阻塞性肺疾病（COPD）患者中阻塞性睡眠呼吸暂停（OSA）症状的高患病率已有报道。关于特应性与OSA之间关系的研究有限。

目的

通过家庭睡眠研究探讨中年慢性阻塞性肺疾病和哮喘患者发生阻塞性睡眠呼吸暂停的风险及其与特应性的关联。

方法

采用Epworth嗜睡量表（ESS）和柏林问卷（BQ）对哮喘和COPD患者进行OSA症状评估。ESS评分≥9分被认为是OSA的高风险。通过ESS和BQ评估为OSA高风险的患者进一步通过家庭睡眠研究进行OSA评估。对这些患者进行针对常见过敏原的皮肤点刺试验以诊断特应性。

结果

在400例患者中（男性229例，占57.25%；女性171例，占42.75%），328例为哮喘患者，72例为COPD患者。ESS和BQ分别在11.25%（45/400）和18.25%（73/400）的患者中呈阳性。ESS在10.67%（35/328）的哮喘患者和13.88%（10/72）的COPD患者中呈阳性。BQ在18.29%（60/328）的哮喘患者和18.05%（13/72）的COPD患者中呈阳性。皮肤点刺试验在74.16%的患者中呈阳性。与COPD患者（16/155，10.32%）相比，哮喘患者中阳性率最高（139/155，89.68%）。对ESS和BQ呈阳性的73例哮喘和COPD患者中的40例进行了皮肤点刺试验。发现72.5%的患者为特应性。在进行家庭多导睡眠图检查的19例患者中，13例患者同意进行常见气传过敏原的皮肤点刺试验，其中9例（69.23%）患者为特应性。