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马提尼克岛肥胖低通气综合征老年患者概况:一项单中心研究

Profiles of Elderly Patients with Obesity Hypoventilation Syndrome in Martinique: A Single-Center Study.

作者信息

Agossou Moustapha, Simo-Tabué Nadine, Dufeal Marion, Awanou Bérénice, Provost Mathilde, Smith Ketty, Badaran Elena, Zouzou Adel, Ahouansou Nelly, Tabué-Teguo Maturin, Dramé Moustapha

机构信息

Department of Respiratory Medicine, CHU of Martinique, 97261 Fort-de-France, France.

Department of Geriatrics, CHU of Martinique, 97261 Fort-de-France, France.

出版信息

J Pers Med. 2023 Jun 30;13(7):1089. doi: 10.3390/jpm13071089.

Abstract

Obesity hypoventilation syndrome (OHS) is a form of chronic respiratory insufficiency related to obesity that affects young and old people. Age appears to be associated with poorer response to treatment by nighttime ventilation. This study aimed to describe the characteristics of elderly subjects (>65 years) with OHS compared to younger patients, with a view to adapting therapy in older individuals. We conducted a retrospective study comparing socio-demographic, clinical, functional characteristics as well as treatment and outcomes between young (<65 years) and older (65 years and older) individuals with OHS at the University Hospital of Martinique. We included 143 patients (114 women), of whom 82 were 65 years or older (57%). Charlson index was higher in the older group. Patients in ≥65 years group were less frequently obese, but more frequently had diabetes mellitus, cardiac arrythmia and arterial hypertension compared to younger patients. There was no difference in the circumstances of diagnosis or arterial blood gas at diagnosis. At follow up, partial pressure of carbon dioxide (pCO) was higher in ≥65 years group. Despite comparable NIV settings, apart from lower expiratory positive airway pressure (EPAP) with higher apnea-hypopnea index (AHI), patients in the ≥65-year-old group remained more frequently hypercapnic. In conclusion, over half (57%) of patients with OHS in our cohort were aged over 65 years. Older patients developed OHS at lower BMI levels than their younger counterparts, and more frequently, had comorbidities such as diabetes, hypertension and cardiac arrhythmia. Increased Charlson index, lower BMI and female sex were independent factors associated with OHS in the elderly.

摘要

肥胖低通气综合征(OHS)是一种与肥胖相关的慢性呼吸功能不全形式,影响年轻人和老年人。年龄似乎与夜间通气治疗反应较差有关。本研究旨在描述老年(>65岁)OHS患者与年轻患者相比的特征,以期调整老年个体的治疗方案。我们进行了一项回顾性研究,比较了马提尼克大学医院年轻(<65岁)和老年(65岁及以上)OHS患者的社会人口统计学、临床、功能特征以及治疗和结局。我们纳入了143例患者(114例女性),其中82例年龄在65岁及以上(57%)。老年组的查尔森指数更高。与年轻患者相比,≥65岁组患者肥胖的频率较低,但糖尿病、心律失常和动脉高血压的发生率更高。诊断情况或诊断时的动脉血气分析无差异。随访时,≥65岁组的二氧化碳分压(pCO)更高。尽管无创通气(NIV)设置相当,但除了呼气末正压(EPAP)较低且呼吸暂停低通气指数(AHI)较高外,≥65岁组患者高碳酸血症的发生率仍然更高。总之,我们队列中超过一半(57%)的OHS患者年龄超过65岁。老年患者发生OHS时的体重指数(BMI)水平低于年轻患者,且更常伴有糖尿病、高血压和心律失常等合并症。查尔森指数升高、BMI降低和女性性别是老年OHS的独立相关因素。

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