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阻塞性睡眠呼吸暂停增加慢性阻塞性肺疾病患者高血压的患病率。

Obstructive Sleep Apnea Increases the Prevalence of Hypertension in Patients with Chronic Obstructive Disease.

机构信息

Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China.

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

COPD. 2020 Oct;17(5):523-532. doi: 10.1080/15412555.2020.1815688. Epub 2020 Sep 9.

Abstract

Whether there are increased rates of chronic diseases associated with the combination of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) overlap syndrome (OVS) has not been determined. The purpose of this study was to assess the prevalence of five comorbidities in COPD and OVS patients. A total of 968 patients with confirmed COPD were included in this study. Participants were requested to fill out a questionnaire involving their basic information and medical history. All subjects underwent one overnight polysomnography and were then divided into an OVS group or a COPD only group according to their apnea-hypopnea index. The prevalence of hypertension, diabetes, cardiovascular disease, arrhythmia and cerebrovascular disease were compared and risk factors for comorbidities in COPD patients were identified. Compared with the COPD only group, the prevalence of hypertension was significantly higher in the OVS group, however, the prevalence rates of the other four kinds of diseases were not statistically different between the two groups. In COPD patients, the prevalence of hypertension increased with the severity of OSA and the prevalence of arrhythmia increased with airflow limitation severity. Risk factors for OSA in patients with COPD included BMI, FEV%, Epworth Sleepiness Scale score and the Sleep Apnea Clinical Score. OSA was an independent risk factor for hypertension. The other risk factors for hypertension in COPD patients included age, BMI, CAT score and alcohol consumption. Age, lower FEV% may be risk factors for arrhythmia. OVS patients were associated with a high prevalence rate of hypertension, while OSA was an independent risk factor for hypertension.

摘要

尚未确定与慢性阻塞性肺疾病(COPD)和阻塞性睡眠呼吸暂停(OSA)重叠综合征(OVS)相关的慢性疾病发生率是否增加。本研究的目的是评估 COPD 和 OVS 患者五种合并症的患病率。本研究共纳入 968 例确诊的 COPD 患者。要求参与者填写一份包含基本信息和病史的问卷。所有受试者均接受了一夜多导睡眠图检查,然后根据呼吸暂停低通气指数将其分为 OVS 组或 COPD 组。比较了高血压、糖尿病、心血管疾病、心律失常和脑血管疾病的患病率,并确定了 COPD 患者合并症的危险因素。与 COPD 组相比,OSA 组的高血压患病率明显更高,但两组其他四种疾病的患病率无统计学差异。在 COPD 患者中,高血压的患病率随着 OSA 严重程度的增加而增加,心律失常的患病率随着气流受限严重程度的增加而增加。COPD 患者 OSA 的危险因素包括 BMI、FEV%、Epworth 睡眠量表评分和睡眠呼吸暂停临床评分。OSA 是高血压的独立危险因素。COPD 患者高血压的其他危险因素包括年龄、BMI、CAT 评分和饮酒。年龄、较低的 FEV%可能是心律失常的危险因素。OSV 患者与高血压的高患病率相关,而 OSA 是高血压的独立危险因素。

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