重叠综合征夜间低氧与肺功能相关性的临床研究

目的观察重叠综合征患者夜间呼吸紊乱、低氧情况及肺功能的改变,探讨重叠综合征的发病机制。方法对42例重叠综合征、30例COPD患者进行PSG监测,并行肺功能检查,记录AHI、Lapnea、LSaO2、SaO2<90%时间及FEV1、FEV1/FVC、FEF50%、FEF25%。结果重叠综合征患者BMI、AHI、Lapnea、SaO2<90%时间较单纯COPD患者明显增加;LSaO2及FEV1、FEV1/FVC、FEF50%、FEF25%较单纯COPD患者明显下降;重叠综合征患者FEV1/FVC、FEF50%、FEF25%与AHI、SaO2<90%时间呈负相关,与LSaO2呈正相关。结论重叠综合征患者较单纯COPD患者夜间低氧明显;夜间低氧原因除了上气道阻力增加外,COPD本身引起肺功能不完全可逆性改变也占主要的作用;同时睡眠呼吸紊乱亦可加重肺功能损害。

Clinical analysis of night hypoxemia and pulmonary function in patients with overlap syndrome

Objective To discuss the pathogenesis of overlap syndrome through investigating sleep-related respiration disorder,hypoxemia and pulmonary function.Methods 42 cases of overlap syndrome and 30 cases of chronic obstructive pulmonary disease(COPD)were examined polysomnography and pulmonary function,including body mass index(BMI),apnea hypopnea index(AHI),the longest time of apnea(L apnea),the lowest oxygen saturation(L SaO2),the accumulated time when SaO2 was lower than 90%(SaO2 <90%),FEV1,FEV1/FVC,FEF50% and FEF25%.Results BMI,AHI,L apnea,the accumulated time of SaO2 <90% in patients of overlap syndrome were significantly higher than those in COPD patients;L SaO2,FEV1,FEV1/FVC,FEF50% and FEF25% in patients of overlap syndrome were lower than those in COPD patients;FEV1/FVC,FEF50% and FEF25% were inversely correlated with AHI and the accumulated time of SaO2 <90%,and positively correlated with L SaO2 in overlap syndrome.Conclusion More sleep-related hypoxemia were found in overlap syndrome than that in COPD,the increase of resistance of upper airway and incompletely reversible airflow obstructive of COPD may play an important role in overlap syndrome.Moreover,respiration disorder related with sleep may damage pulmonary function.