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慢性阻塞性肺疾病中的睡眠诱发低氧血症

Sleep induced hypoxemia in chronic obstructive pulmonary disease.

作者信息

Zhang Jing, Wang Yan, Feng Jing, Sun Xin

机构信息

Respiratory Department of Tianjin Medical University General Hospital, Tianjin 300052, China.

Respiratory Department of Tianjin Haihe Hospital, Tianjin 300350, China.

出版信息

JNMA J Nepal Med Assoc. 2013 Jul-Sep;52(191):528-33.

Abstract

Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality worldwide. Sleep-induced hypoxemia is defined as "an SpO2 (oxyhemoglobin saturation) during sleep of < 90% for more than five minutes with a nadir of at least 85%" or "> 30% of total sleep time with an SpO2 of < 90%" in subject with a baseline awake SpO2 of ≥ 90%. Patients with moderate or severe COPD run a high risk of developing SIH mainly because of alveolar hypoventilation and ventilation-perfusion mismatch. Compared to their non-SIH brethren, SIH COPD patients have greater degrees of pulmonary hypertension and cor pulmonale, require more frequent hospitalizations, and sustain higher mortality rates. And the necessity of treatment of isolated SIH in COPD has been debated for years. In this mini review, the definition, reasons, prevalence, clinical significance and treatment approaches of SIH in COPD are summarized.

摘要

慢性阻塞性肺疾病是全球发病和死亡的主要原因。睡眠性低氧血症定义为:在基线清醒状态下SpO2(氧合血红蛋白饱和度)≥90%的受试者中,“睡眠期间SpO2<90%持续超过5分钟且最低点至少为85%”或“SpO2<90%的时间占总睡眠时间的30%以上”。中重度慢性阻塞性肺疾病患者发生睡眠性低氧血症的风险很高,主要原因是肺泡通气不足和通气/血流不匹配。与无睡眠性低氧血症的慢性阻塞性肺疾病患者相比,有睡眠性低氧血症的慢性阻塞性肺疾病患者的肺动脉高压和肺心病程度更严重,需要更频繁住院,死亡率更高。而慢性阻塞性肺疾病中单纯睡眠性低氧血症的治疗必要性多年来一直存在争议。在这篇小型综述中,总结了慢性阻塞性肺疾病中睡眠性低氧血症的定义、原因、患病率、临床意义和治疗方法。

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