CAJ | 학술논문

目的：分析阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并慢性阻塞性肺疾病（COPD）的重叠综合征（OS）患者的临床特点，提高对该病的认识。方法筛选OSAHS、COPD及OS患者各42例，正常对照20名，采集病史，测量身高、体重、颈围，记录Epworth嗜睡评分（ESS），行多导睡眠监测，血常规、超敏C反应蛋白（hsCRP）及肺功能检查，比较各组间的指标，并进行统计学分析。结果 OS组的体重指数（BMI）、颈围和ESS均显著高于对照组和COPD组。与对照组相比，OS组、OSAHS组及COPD组均存在不同程度的夜间缺氧，其中OS组程度最重。OS组和COPD组第一秒用力呼气容积（FEV1）、FEV1/用力肺活量（FVC），FEV1占预计值百分比（FEV1%）均低于OSAHS组和对照组，且OS组较COPD组下降更明显；OS组的血红蛋白、hsCRP均高于其他3组。结论 COPD伴有肥胖的患者更易患OS。OS患者夜间缺氧，白天嗜睡、肺功能减退及系统性炎症反应较单纯OSAHS或单纯COPD更严重，需引起临床医生重视。
목적：분석조새성수면호흡잠정저통기종합정（OSAHS）합병만성조새성폐질병（COPD）적중첩종합정（OS）환자적림상특점，제고대해병적인식。방법사선OSAHS、COPD급OS환자각42례，정상대조20명，채집병사，측량신고、체중、경위，기록Epworth기수평분（ESS），행다도수면감측，혈상규、초민C반응단백（hsCRP）급폐공능검사，비교각조간적지표，병진행통계학분석。결과 OS조적체중지수（BMI）、경위화ESS균현저고우대조조화COPD조。여대조조상비，OS조、OSAHS조급COPD조균존재불동정도적야간결양，기중OS조정도최중。OS조화COPD조제일초용력호기용적（FEV1）、FEV1/용력폐활량（FVC），FEV1점예계치백분비（FEV1%）균저우OSAHS조화대조조，차OS조교COPD조하강경명현；OS조적혈홍단백、hsCRP균고우기타3조。결론 COPD반유비반적환자경역환OS。OS환자야간결양，백천기수、폐공능감퇴급계통성염증반응교단순OSAHS혹단순COPD경엄중，수인기림상의생중시。
Objective To analyze the clinical characteristics of obstructive sleep apnea hypopnea syndrome (OSAHS) - chronic obstructive pulmonary disease (COPD) overlap syndrome (OS), so as to gain a profound understanding in this condition.Methods 42 cases of OSAHS, 42 cases of COPD, 42 cases of OS and 20 cases as normal control were enrolled. Patient history, height, weight, neck circumference (NC), Epworth sleepiness scale (ESS), polysomnogram, blood routine, high-sensitivity C-reactive protein (hsCRP) and pulmonary function tests were measured and analyzed.Results BMI, NC and ESS were signifi cantly higher in OS patients than those in the COPD group and the normal control. Patients with OS, OSAHS and COPD had varying degrees of nocturnal hypoxia, which was most serious in those with OS. FEV1, FEV1/FVC and FEV1% in OS group and COPD group were lower than those in OSAHS group and the control group. Moreover, FEV1, FEV1/FVC, and FEV1% in the OS group was significantly lower than those in the COPD group. Hemoglobumin and hsCRP were higher in OS group than those in the other three groups.Conclusion COPD patients with obesity are more susceptible to OS. Suffering with nocturnal hypoxia, daytime drowsiness, compromised pulmonary function and systemic inflammatory response, OS patients have a more severe condition than those simply with OSAHS or COPD,which should be noticed by clinicians.