摘要
目的:研究支气管哮喘(哮喘)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床特点,探讨不同程度的OSAHS与哮喘的关系,为临床诊治提供理论依据。方法:回顾性研究。分析2018年8月至2019年12月河北省胸科医院收治的96例OSAHS合并哮喘患者的临床资料,根据睡眠呼吸暂停低通气指数(AHI)进行严重度分级,分为轻度、中度、重度3组,每组32例。对比3组患者性别、年龄、体质量指数(BMI)、吸烟指数、动脉血气[动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、碳酸氢根(HCO_(3)^(-))]、运动心肺功能及经皮二氧化碳分压(TcPCO_(2))。结果:重度组血氧饱和度水平明显低于轻度组和中度组;哮喘严重程度随OSAHS病情严重程度增加而增加;AHI及最长呼吸暂停时间均显著高于轻度组和中度组;重度组PaCO_(2)水平显著高于轻度组和中度组,PaO_(2)、HCO_(3)水平显著低于其他2组;重度组用力肺活量及呼气流量峰值水平均显著低于轻度组和中度组;重度组最高T CPCO_(2)及清醒期T CPCO_(2)均显著高于轻度组和中度组,各组间对比差异均有统计学意义(P值均<0.05)。结论:OSAHS合并哮喘会加重患者睡眠呼吸紊乱情况,延长患者呼吸暂停时间。此外,还会对患者心肺功能及动脉血气造成损害,加大引发低氧高碳酸血症的风险,严重威胁患者的生命健康安全,应采取相应措施及时治疗。
Objective To study the clinical characteristics of bronchial asthma(asthma)with obstructive sleep apnea hypopnea syndrome(OSAHS),discuss the relationship between OSAHS and asthma in different degrees,and provide theoretical basis for clinical diagnosis and treatment.Methods A total of 96 OSAHS patients with asthma admitted to Chest Hospital of Hebei Province from August 2018 to December 2019 were selected.Severity was graded according to the sleep apnea hypopnea index(AHI),and they were divided into three groups:mild,moderate and severe,with 32 patients in each group.Sex,age,body mass index(BMI),smoking index,arterial blood gas(partial pressure of carbon dioxide[PaCO_(2)],partial pressure of oxygen[PaO_(2)],bicarbonate[HCO_(3)^(-)]),cardiorespiratory function and percutaneous PaCO_(2)were compared among the three groups.Results SpO_(2)level of the severe group was significantly lower than that of the mild group and the moderate group.The severity of asthma increased with the severity of OSAHS.AHI and longest apnea time in the severe group were significantly higher than those in the mild and moderate groups.The levels of PaCO_(2)in the severe group were significantly higher than those in the mild and moderate groups,and the levels of PaO_(2) and HCO_(3) were significantly lower than those in the other two groups.The levels of FVC and PEF in the severe group were significantly lower than those in the mild group and the moderate group.The highest TCPCO_(2) and waking TCPCO_(2) in the severe group were significantly higher than those in the mild and moderate groups(all P<0.05).Conclusions OSAHS combined with asthma can aggravate the sleep-disordered breathing and prolong the apnea time.In addition,it will damage the patients′cardiopulmonary function and arterial blood gas,increase the risk of hypoxic hypercapnia,seriously threaten the patients′life and health safety,so appropriate measures should be taken for timely treatment.
作者
王彩彩
唐茜
王红景
王亮
Wang Caicai;Tang Qian;Wang Hongjing;Wang Liang(The Third Department of Respiratory and Critical Care Medicine,Chest Hospital of Hebei Province,Shijiazhuang 050000,China;The Second Department of Respiratory and Critical Care Medicine,Chest Hospital of Hebei Province,Shijiazhuang 050000,China)
出处
《国际呼吸杂志》
2021年第16期1240-1245,共6页
International Journal of Respiration
基金
河北省2018年度医学科学研究重点课题计划项目(20180650)。
关键词
哮喘
阻塞性睡眠呼吸暂停低通气综合征
睡眠呼吸紊乱
心肺功能
Asthma
Obstructive sleep apnea hypopnea syndrome
Sleep-disordered breathing
Cardiopulmonary function
