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阻塞性睡眠呼吸暂停(OSAS)和重叠型 COPD-OSAS 患者的合并症负担。

Burden of Comorbidities in Patients with OSAS and COPD-OSAS Overlap Syndrome.

机构信息

MSc Program in Sleep Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

Department of Pneumonology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

出版信息

Medicina (Kaunas). 2021 Nov 4;57(11):1201. doi: 10.3390/medicina57111201.

Abstract

: Obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD) are usually associated with multi-morbidity. The aim of this study was to retrospectively investigate the prevalence of comorbidities in a cohort of patients with OSAS and COPD-OSAS overlap syndrome (OS) patients and to explore differences between these two groups. : Included were consecutive OS patients and OSAS patients who had been referred to our sleep laboratory, and were matched in terms of sex, age, BMI, and smoking history. Presence of comorbidities was recorded based on their medical history and after clinical and laboratory examination. : The two groups, OS patients ( = 163, AHI > 5/h and FEV/FVC < 0.7) and OSAS patients ( = 163, AHI > 5/h, and FEV/FVC > 0.7), did not differ in terms of apnea hypopnea index ( = 0.346), and oxygen desaturation index ( = 0.668). Compared to OSAS patients, OS patients had lower average SpO ( = 0.008) and higher sleep time with oxygen saturation <90% ( = 0.002) during sleep, and lower PaO ( < 0.001) and higher PaCO ( = 0.04) in wakefulness. Arterial hypertension was the most prevalent comorbidity for both OS and OSAS, followed by dyslipidemia, cardiovascular disease (CVD) and diabetes. OS was characterized by a higher prevalence of total comorbidities (median (IQR):2 (1-3) vs. 2 (1-2), = 0.033), which was due to the higher prevalence of CVD ( = 0.016) than OSAS. No differences were observed in other comorbidities. : In OS patients, nocturnal hypoxia and impaired gas exchange in wakefulness are more overt, while a higher burden of CVD is observed among them in comparison to sex-, age- and BMI-matched OSAS patients.

摘要

阻塞性睡眠呼吸暂停综合征(OSAS)和慢性阻塞性肺疾病(COPD)通常与多种疾病相关。本研究旨在回顾性调查 OSAS 和重叠综合征(OS)患者队列中的合并症患病率,并探讨这两组患者之间的差异。

纳入了连续就诊于我们睡眠实验室的 OS 患者和 OSAS 患者,根据性别、年龄、BMI 和吸烟史进行匹配。根据病史以及临床和实验室检查记录合并症的存在情况。

两组患者(OS 患者,n = 163,AHI > 5/h 且 FEV/FVC < 0.7;OSAS 患者,n = 163,AHI > 5/h 且 FEV/FVC > 0.7)的呼吸暂停低通气指数( = 0.346)和氧减指数( = 0.668)没有差异。与 OSAS 患者相比,OS 患者的平均 SpO( = 0.008)更低,睡眠中氧饱和度 <90%的时间更长( = 0.002),清醒时 PaO( < 0.001)更低,PaCO( = 0.04)更高。动脉高血压是 OS 和 OSAS 最常见的合并症,其次是血脂异常、心血管疾病(CVD)和糖尿病。OS 的总合并症患病率更高(中位数(IQR):2(1-3)比 2(1-2), = 0.033),这是由于 CVD 的患病率更高( = 0.016)。其他合并症没有差异。

在 OS 患者中,夜间缺氧和清醒时气体交换受损更为明显,与匹配性别、年龄和 BMI 的 OSAS 患者相比,他们的 CVD 负担更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0630/8623094/1ac71286e9cf/medicina-57-01201-g001.jpg

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