Du Wei, Liu Jun, Zhou Jianlong, Ye Dan, OuYang Yan, Deng Qingnan
Respiratory Diseases Group, the 6th Unit, Department of Internal Medicine, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China.
Department of Gerontology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China.
Int J Chron Obstruct Pulmon Dis. 2018 Feb 27;13:665-674. doi: 10.2147/COPD.S148735. eCollection 2018.
The aim of this study was to investigate the role of obstructive sleep apnea (OSA) on all-cause mortality in patients with COPD.
Data for this cross-sectional study were obtained from the National Health and Nutrition Examination Survey (NHANES) data (year 2005-2008). Eligible subjects were ≥20 years who had no COPD or OSA (n=9,237), had only OSA (n=366), had only COPD (n=695), and had OSA/COPD overlap syndrome (n=90). Univariate and multivariate analyses were used to evaluate factors associated with overall mortality.
Multivariate analysis found that the COPD and OSA/COPD overlap syndrome groups had significantly higher chance of all-cause mortality than the group of subjects who did not have OSA or COPD (adjusted hazard ratio [HR] =1.5 for the COPD group and 2.4 for the overlap syndrome group) (≤0.007). Although not significant, having OSA/COPD overlap syndrome was associated with higher likelihood of death than COPD alone (HR =1.5; =0.160). Other factors associated with higher overall mortality were aging, poorer family status, current smoker, serum vitamin D deficiency, cardiovascular disease, history of cancer, diabetes, and impaired renal function.
The present study found that COPD and OSA/COPD overlap syndrome were associated with higher all-cause mortality compared with patients without either disease and that OSA did not significantly increase mortality in patients with COPD.
本研究旨在探讨阻塞性睡眠呼吸暂停（OSA）在慢性阻塞性肺疾病（COPD）患者全因死亡率中的作用。
本横断面研究的数据来自国家健康与营养检查调查（NHANES）数据（2005 - 2008年）。符合条件的受试者年龄≥20岁，其中无COPD或OSA者（n = 9237）、仅有OSA者（n = 366）、仅有COPD者（n = 695）以及患有OSA/COPD重叠综合征者（n = 90）。采用单因素和多因素分析评估与总体死亡率相关的因素。
多因素分析发现，COPD组和OSA/COPD重叠综合征组的全因死亡风险显著高于无OSA或COPD的受试者组（COPD组调整后风险比[HR] = 1.5，重叠综合征组为2.4）（P≤0.007）。虽然无统计学意义，但与单纯COPD相比，患有OSA/COPD重叠综合征的患者死亡可能性更高（HR = 1.5；P = 0.160）。与总体死亡率较高相关的其他因素包括年龄增长、家庭状况较差、当前吸烟者、血清维生素D缺乏、心血管疾病、癌症病史、糖尿病和肾功能受损。
本研究发现，与无这两种疾病的患者相比，COPD和OSA/COPD重叠综合征与更高的全因死亡率相关，且OSA并未显著增加COPD患者的死亡率。
