孟买一家三级护理医院肺病科间质性肺疾病患者睡眠呼吸障碍和阻塞性睡眠呼吸暂停的患病率及概况
Prevalence and profile of sleep-disordered breathing and obstructive sleep apnea in patients with interstitial lung disease at the pulmonary medicine department of a tertiary care hospital in Mumbai.
作者信息
Utpat Ketaki, Gupta Abhishek, Desai Unnati, Joshi Jyotsna M, Bharmal Ramesh N
机构信息
Department of Pulmonary Medicine, T. N. Medical College, B.Y.L. Nair Hospital, Mumbai, Maharashtra, India.
出版信息
Lung India. 2020 Sep-Oct;37(5):415-420. doi: 10.4103/lungindia.lungindia_6_20.
BACKGROUND
Sleep-disordered breathing (SDB), predominantly obstructive sleep apnea (OSA), is a frequent phenomenon in interstitial lung disease (ILD) and may be associated with significant morbidity and mortality.
METHODOLOGY
A prospective, observational, hospital-based study was conducted in a tertiary care hospital after ethics committee permission. The study group consisted of 100 consecutive ILD patients diagnosed by a multidisciplinary diagnosis. They were evaluated for the prevalence of SDB with a polysomnography after a comprehensive history, detailed clinical examination, calculation of various pretest probability scores, and relevant prerequisite workup.
RESULTS
Out of the total 100 ILD patients, 44 were male (44%) and 56 were female (56%). SDB was present in 57 (57%) patients. Of these, 29 (29%) were found to have only nocturnal oxygen desaturation (NOD), while 28 (28%) had OSA. The 28 cases of OSA were distributed as 15 mild OSA (53.57%), 10 moderate OSA (35.71%), and 3 severe OSA (10.71%). The patients were divided into the following four groups: total study Group (A), patients with OSA (Group B), patients with NOD without OSA (Group C), and no SDB (Group D). The mean forced vital capacity values predicted in the four groups were 53.67%, 50%, 45.56%, and 57.87%, respectively. The mean body mass index in the four groups was 24.56, 27, 26.98, and 24.89 kg/m, respectively. The mean 6-min walk distance in the four groups was 280.7, 250, 256.65, and 311.4 m, respectively. The mean partial pressure of oxygen in the four groups was 65.65, 60, 62.10, and 75.66 mmHg, respectively. The mean apnea-hypopnea index in the study group was 2.98/h, 8.6/h with mild OSA, 21.69/h with moderate OSA, 48.78/h with severe OSA, 3.89/h in patients having NOD without OSA, and 2.54/h in patients with no SDB.
CONCLUSION
SDB in ILD is associated with a significant impact on the cardinal determinants of functional capacity, lung function, and quality of life.
背景
睡眠呼吸障碍（SDB），主要是阻塞性睡眠呼吸暂停（OSA），是间质性肺疾病（ILD）中的常见现象，可能与显著的发病率和死亡率相关。
方法
在获得伦理委员会许可后，于一家三级医疗中心进行了一项前瞻性、观察性、基于医院的研究。研究组由100例经多学科诊断确诊的连续ILD患者组成。在进行全面病史采集、详细临床检查、计算各种预测试概率评分以及相关必要检查后，通过多导睡眠图评估SDB的患病率。
结果
100例ILD患者中，男性44例（44%），女性56例（56%）。57例（57%）患者存在SDB。其中，29例（29%）仅发现夜间氧饱和度下降（NOD），28例（28%）患有OSA。28例OSA病例分布为15例轻度OSA（53.57%）、10例中度OSA（35.71%）和3例重度OSA（10.71%）。患者分为以下四组：总研究组（A组）、OSA患者（B组）、无OSA的NOD患者（C组）和无SDB患者（D组）。四组预测的平均用力肺活量值分别为53.67%、50%、45.56%和57.87%。四组的平均体重指数分别为24.56、27、26.98和24.89kg/m²。四组的平均6分钟步行距离分别为280.7、250、256.65和311.4m。四组的平均氧分压分别为65.65、60、62.10和75.66mmHg。研究组的平均呼吸暂停低通气指数为2.98次/小时，轻度OSA患者为8.6次/小时，中度OSA患者为21.69次/小时，重度OSA患者为48.78次/小时，无OSA的NOD患者为3.89次/小时，无SDB患者为2.54次/小时。
结论
ILD中的SDB对功能能力、肺功能和生活质量的主要决定因素有显著影响。
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