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_AASM20072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。

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 AASM₂₀₁₂ criteria were compared. Differences in sleep parameters and clinical indexes were compared between patients with overlap syndrome who met the AASM₂₀₁₂ not AASM₂₀₀₇ criteria (OS_2012-2007) and COPD patients who only met the AASM₂₀₀₇ criteria (COPD_AASM2007). Results Using the AASM₂₀₁₂ criteria, 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 AASM₂₀₁₂ significantly 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.

目的 比较唑来膦酸对 PVP(椎体成形术)治疗OVCF(骨质疏松椎体压缩性骨折)术后再发骨折的影响。方法 收集2016年12月—2018年6月在我院骨科接受PVP治疗患者共70例,其中40人在术后接受了唑来膦酸治疗(观察组),30人在术后接受了安慰剂治疗(对照组),两组患者均给予维生素D和钙剂基础治疗。记录术后6个月、1年、2年腰椎骨密度;术后2年内伤椎及邻近椎体再发骨折情况。结果 观察组伤椎再发骨折率(1/40,2.5%)低于对照组(2/30,6.67%)(P＜0.05);观察组邻椎再发骨折率(2/40,5%)低于对照组(7/30,23.33%)(P＜0.05)。结论 唑来膦酸能较好地预防PVP术后再发骨折。

Objective To compare the effect of zoledronic acid on the treatment of osteoporotic vertebral compression fracture after percutaneous vertebroplasty PVP. Methods From December 2017 to June 2019, a total of 70 patients who received PVP in the hospital medical plastic surgery clinic, 40 patients were collected received zoledronic acid (group A) and 30 patients received placebo (group B) after operation. Both groups received basic treatment of vitamin D and calcium. The bone mineral densits (BMD) of lumbar vertebrae were recorded at 6 months, 1 year and 2 years after operation, and the recurrent fractures of injured vertebrae and adjacent vertebrae were recorded at 2 years after operation. Results The rate of recurrent fracture of vertebrae in group A (1/40, 2.5%) was lower than that in group B (2/30, 6.67%); the rate of recurrent fracture of adjacent vertebrae in group A (2/40, 5%) was grcartly lower than that in group B (7/30, 23.33%). Conclusion Zoledronic acid can prevent recurrent fracture after PVP.