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慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停重叠综合征住院患者无创正压通气的危险因素分析

Risk factors analysis of noninvasive positive pressure ventilation in inpatients with overlapping syndrome of chronic obstructive pulmonary disease combined with obstructive sleep apnea.

作者信息

Liu WenJing, Ding Fang, Guo Hong, Li JieMei, Guo Wei, Wang Jing, Cui ZhaoBo

机构信息

Department of Respiratory and Critical Care Medicine, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui, Hebei Province, China.

Department of Gerontology, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui, Hebei Province, China.

出版信息

Ann Thorac Med. 2024 Jul-Sep;19(3):201-207. doi: 10.4103/atm.atm_305_23. Epub 2024 Jul 4.

DOI:10.4103/atm.atm_305_23
PMID:39144532
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11321525/
Abstract

OBJECTIVE

The aim of the study was to analyze the clinical data of patients with chronic obstructive pulmonary disease and obstructive sleep apnea overlap syndrome (OS) during hospitalization and to evaluate the risk factors of patients treated with Non-Invasive Ventilation (NIV).

METHODS

Demographic and clinical data of patients with confirmed OS during hospitalization were retrospectively collected. The patients were divided into two groups according to whether noninvasive ventilator was used during hospitalization, including OS treated with NIV (244 cases) and OS without NIV (239 cases). The -test, test, and Kaplan-Meier curve were used to compare the two groups, and multiple logistic regression was used to analyze the risk factors of NIV in patients with OS.

RESULTS

Compared with the OS group without NIV, the pulmonary hypertension, lymphocyte count, and left ventricular ejection fraction% of OS patients with NIV were lower, whereas PCO, uric acid, , procalcitonin, and N-terminal pro-B-type natriuretic peptide were higher, with statistical differences ( < 0.05). During hospitalization and follow-up, OS patients with NIV had a longer hospital stay ( < 0.001), and there was no significant difference in the rate of readmission within 28 days. The logistic regression analysis showed that the history of diuretic use, previous history of noninvasive ventilator use, and ischemic heart disease were independent risk factors for NIV treatment in OS patients during hospitalization.

CONCLUSION

Patients with OS undergoing NIV during hospitalization exhibited more severe overall illness and had prolonged hospital stays compared to OS patients not receiving NIV. History of diuretic use, history of NIV use, and ischemic heart disease are independent risk factors for NIV treatment in OS patients during hospitalization.

摘要

目的

本研究旨在分析慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停重叠综合征(OS)患者住院期间的临床资料,并评估无创通气(NIV)治疗患者的危险因素。

方法

回顾性收集确诊为OS的患者住院期间的人口统计学和临床资料。根据住院期间是否使用无创呼吸机将患者分为两组,包括接受NIV治疗的OS患者(244例)和未接受NIV治疗的OS患者(239例)。采用t检验、χ²检验和Kaplan-Meier曲线对两组进行比较,并采用多因素logistic回归分析OS患者接受NIV治疗的危险因素。

结果

与未接受NIV治疗的OS组相比,接受NIV治疗的OS患者的肺动脉高压、淋巴细胞计数和左心室射血分数%较低,而PCO₂、尿酸、C反应蛋白、降钙素原和N末端B型利钠肽前体较高,差异有统计学意义(P<0.05)。在住院和随访期间,接受NIV治疗的OS患者住院时间较长(P<0.001),28天内再入院率无显著差异。logistic回归分析显示,使用利尿剂史、既往无创呼吸机使用史和缺血性心脏病是OS患者住院期间接受NIV治疗的独立危险因素。

结论

与未接受NIV治疗的OS患者相比,住院期间接受NIV治疗的OS患者总体病情更严重,住院时间更长。使用利尿剂史、NIV使用史和缺血性心脏病是OS患者住院期间接受NIV治疗的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/9687eaac86ee/ATM-19-201-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/305cecdb1891/ATM-19-201-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/17171ac36b5a/ATM-19-201-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/6fa8418bf439/ATM-19-201-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/9687eaac86ee/ATM-19-201-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/305cecdb1891/ATM-19-201-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/17171ac36b5a/ATM-19-201-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/6fa8418bf439/ATM-19-201-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11321525/9687eaac86ee/ATM-19-201-g004.jpg

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