哮喘及哮喘相关合并症：对夜间血氧饱和度的影响。
Asthma and asthma-related comorbidity: effects on nocturnal oxygen saturation.
机构信息
Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
出版信息
J Clin Sleep Med. 2022 Nov 1;18(11):2635-2641. doi: 10.5664/jcsm.10178.
STUDY OBJECTIVES
Nocturnal symptoms are very common in asthma, which is associated with worse sleep quality. The nocturnal oxygen saturation may be decreased in asthma; however, whether this association is dependent on nocturnal asthma symptoms, lung function, coexisting obstructive sleep apnea (OSA), or other asthma-related comorbidities is unknown. The objective of this study was to examine the effects of asthma, OSA, lung function, airway symptoms, and asthma-related comorbidities on the nocturnal oxygen saturation in a cross-sectional community-based population study.
METHODS
In total, 395 women and 392 men underwent overnight polysomnography, performed spirometry, and completed questionnaires on airway symptoms and asthma-related comorbidities.
RESULTS
Participants with asthma (n = 88) had a lower nocturnal oxygen saturation than those without asthma (93.8% vs 94.3%, = .01) also after adjusting for comorbidity, age, body mass index, and smoking status (coefficient -0.38; CI -0.67, -0.10; < .01). The nocturnal oxygen saturation was lower among participants with wheezing, nocturnal chest tightness, fixed airflow limitation, gastroesophageal reflux, obesity, and OSA than in those without these conditions. The associations between lower oxygen saturation and wheezing, forced expiratory volume in 1 second, gastroesophageal reflux, and apnea-hypopnea index were significant also after adjusting for age, sex, body mass index, and smoking status. Participants with both wheezing and OSA had a significantly lower nocturnal oxygen saturation (92.5 ± 0.5%) than participants with wheezing only (94.3 ± 0.3%) and OSA only (93.6 ± 0.2% %) ( < .01).
CONCLUSIONS
Participants with asthma displayed a lower mean oxygen saturation during sleep, which could not be explained only by coexisting OSA or obesity. Also, asthma symptoms and lung function were associated with lower nocturnal oxygen saturation. The lower oxygen saturation seen in asthma is hence multifactorial in origin and is a result of the combination of symptoms, lung function, and comorbidity.
CITATION
Sundbom F, Janson C, Ljunggren M, Lindberg E. Asthma and asthma-related comorbidity: effects on nocturnal oxygen saturation. . 2022;18(11):2635-2641.
研究目的
哮喘患者夜间症状非常常见，且与睡眠质量较差相关。哮喘患者夜间的血氧饱和度可能会降低；然而，这种关联是否依赖于夜间哮喘症状、肺功能、并存的阻塞性睡眠呼吸暂停（OSA）或其他与哮喘相关的合并症尚不清楚。本研究的目的是在一项基于社区的横断面人群研究中，检查哮喘、OSA、肺功能、气道症状和与哮喘相关的合并症对夜间血氧饱和度的影响。
方法
共有 395 名女性和 392 名男性接受了过夜多导睡眠图检查，进行了肺功能检查，并完成了气道症状和与哮喘相关的合并症问卷。
结果
与无哮喘的参与者相比（93.8% 对 94.3%，=0.01），哮喘患者（n=88）的夜间血氧饱和度较低，且调整合并症、年龄、体重指数和吸烟状况后仍如此（系数-0.38；CI-0.67，-0.10；<0.01）。与无喘息、夜间胸闷、固定气流受限、胃食管反流、肥胖和 OSA 的参与者相比，有喘息、夜间胸闷、固定气流受限、胃食管反流、肥胖和 OSA 的参与者的夜间血氧饱和度较低。调整年龄、性别、体重指数和吸烟状况后，低血氧饱和度与喘息、1 秒用力呼气量、胃食管反流和呼吸暂停-低通气指数之间的相关性仍然显著。同时患有喘息和 OSA 的参与者的夜间血氧饱和度明显低于仅患有喘息（94.3%±0.3%）和仅患有 OSA（93.6%±0.2%）的参与者（<0.01）。
结论
患有哮喘的参与者在睡眠期间的平均血氧饱和度较低，这不能仅用并存的 OSA 或肥胖来解释。此外，哮喘症状和肺功能与夜间血氧饱和度降低有关。哮喘患者的低血氧饱和度是多因素的，是症状、肺功能和合并症共同作用的结果。
引文
Sundbom F, Janson C, Ljunggren M, Lindberg E. 哮喘与哮喘相关的合并症：对夜间血氧饱和度的影响。 2022;18(11):2635-2641。
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