比较不同判读标准对COPD合并OSA的诊断及其特点的影响

doi:10.3969/j.issn.1000-8535.2022.06.003

摘要/Abstract

摘要： 目的比较2012版和2007版美国睡眠医学会判读标准(AASM₂₀₁₂和AASM₂₀₀₇)对慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSA)的诊断及其睡眠和临床特点的影响。方法分别采用AASM₂₀₀₇与AASM₂₀₁₂分析41名稳定期COPD患者的睡眠呼吸事件,比较两种判读标准对COPD患者的呼吸暂停低通气指数(AHI),合并OSA的比例的影响;再对符合AASM₂₀₁₂但不符合AASM₂₀₀₇诊断的重叠综合征患者(OS_2012-2007)与仅符合AASM₂₀₀₇诊断的COPD患者(COPD_AASM2007)的睡眠参数和临床指标进行比较。结果对比AASM₂₀₀₇,AASM₂₀₁₂显著增加COPD的睡眠呼吸暂停低通气指数(AHI)[1.0 (1.0, 7.5) h^-1 vs 11.5 (4.1, 25.1) h^-1, P<0.001],及合并OSA的比例(36.6% vs 70.7%, P<0.05)。OS_2012-2007与COPD_AA_SM20072组之间的微觉醒指数与3期睡眠比例有统计学差异,但其他睡眠参数、血压及高血压患病人数均无明显差异。结论 AASM₂₀₁₂显著增加COPD患者AHI,及合并OSA的比例,但初步的结果提示 AASM₂₀₁₂下新增的OS_2012-2007患者的病理损害相对少且轻。

关键词: 慢性阻塞性肺疾病, 阻塞性睡眠呼吸暂停, 重叠综合征, 睡眠呼吸暂停低通气指数, 美国睡眠医学会

Abstract: Objective To compare the effects of the 2012 and 2007 American Academy of Sleep Medicine (AASM₂₀₁₂ and AASM₂₀₀₇) scoring criteria on the diagnosis, sleep and clinical characteristics of chronic obstructive pulmonary disease (COPD) with obstructive sleep apnea (OSA). Methods AASM₂₀₀₇ and AASM₂₀₁₂ were used to analyze the sleep respiratory events of 41 patients with stable COPD. Differences in apnea-hypopnea index (AHI) and diagnosis of OSA in COPD patients between AASM₂₀₀₇ and AASM₂₀₁₂criteria were compared.Differences in sleep parameters and clinical indexes were compared between patients with overlap syndrome who met the AASM₂₀₁₂ not AASM₂₀₀₇criteria (OS_2012-2007) and COPD patients who only met the AASM₂₀₀₇criteria (COPD_AASM2007). Results Using the AASM₂₀₁₂criteria, the number of AHI [1.0 (1.0, 7.5) h^-1 vs 11.5 (4.1, 25.1) h^-1, P<0.001] and the proportion complicated with OSA (36.6% vs 70.7%, P<0.05) significantly increased compared to the AASM₂₀₀₇ criteria. There was a significant difference between OS_2012-2007 and COPD_AASM2007 in arousal index and third stage of sleep, but no significant difference in other sleep parameters, blood pressure and the number of patients with hypertension. Conclusions Using AASM₂₀₁₂significantly increased AHI and the proportion complicated with OSA in COPD patients, but the preliminary results demonstrated that pathological damages of OS_2012-2007 were relatively mild.

Key words: chronic obstructive pulmonary disease, obstructive sleep apnea, overlap syndrome, sleep apnea-hypopnea index, American Academy of Sleep Medicine

李峰, 伍颖欣. 比较不同判读标准对COPD合并OSA的诊断及其特点的影响[J]. 广州医药, 2022, 53(6): 14-17.

LI Feng, WU Yingxin. Effects of the different scoring criteria on the diagnosis and characteristics of COPD with OSA[J]. Guangzhou Medical Journal, 2022, 53(6): 14-17.

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