【摘要】 目的 探讨重叠综合征（OVS）与单纯慢性阻塞性肺疾病（COPD）患者共病患病率的差异及呼吸暂停低通气指数（AHI）、脉搏血氧饱和度（SpO₂）<90%占总睡眠时间的百分比（T90）与共病患病率之间的潜在联系。方法 根据是否合并阻塞性睡眠呼吸暂停（OSA）,将847例COPD患者分为单纯COPD组（208例）和OVS组（639例）;根据T90将847例COPD患者分为T90>20%组（191例）和T90≤20%组（656例）;再根据AHI将OVS组患者分为5次/h≤AHI<15次/h组（低AHI组，322例）、15次/h≤AHI<30次/h组（中AHI组，199例）及AHI≥30次/h组（高AHI组，118例）。比较各组患者的共病情况。结果 OVS组合并高血压病、心血管疾病、共病数量≥1种、共病数量≥2种患者比例及共病总数量均高于单纯COPD组（P<0.05）,两组患者最常见的共病均为心血管疾病（高血压病、心律失常、冠心病）及糖尿病。不同AHI组别患者BMI、ODI、T90随AHI增大而增加，夜间最低SpO₂随AHI增大而降低；高AHI组患者颈围高于其余两组，夜间平均SpO₂低于其余两组；高AHI组FEV₁/FVC及ESS>10分患者比例均高于低AHI组（P<0.05）。不同AHI组别共病数量≥2种患者比例随AHI增大而升高；中AHI组共病总数量高于低AHI组；高AHI组合并高血压病、肺动脉高压患者比例及共病总数量均高于低AHI组（P<0.05）。T90>20%组合并高血压病、肺动脉高压、共病数量≥2种患者比例及共病总数量均显著高于T90≤20%组（P<0.001）。结论 与单纯COPD患者比较，OVS患者的共病患病率更高。AHI≥15次/h的OVS患者及T90>20%的COPD患者共病患病率较高。更多还原

【Abstract】 Objective To explore the difference in prevalence of co-morbidities between patients with chronic obstructive pulmonary disease（COPD） complicated with obstructive sleep apnea（OSA） overlap Syndrome（OVS） and patients with chronic obstructive pulmonary disease（COPD） alone, and the potential relationship between prevalence of co-morbidities and apnea hypopnea index（AHI）,pulse oxygen saturation（SpO₂）<90% of the total sleep time（T90）.Methods According to whether obstructive sleep apnea（OSA） was merged or not, 847 patients with COPD were divided into alone COPD group（208 cases） and OVS group（639 cases）.According to T90,847 patients with COPD were divided into T90>20% group（191 cases） and T90≤ 20% group（656 cases）.Patients in OVS group were divided into 5 times/h≤AHI<15 times/h group（322 cases）,15 times/h≤AHI<30 times/h group（199 cases） and AHI≥30 times/h group（118 cases） according to AHI.Co-morbidities of each group were compared.ResultsProportion of patients with hypertension, cardiovascular disease, number of comorbidities ≥1,number of comorbidities ≥2 and the total number of diseases in OVS group were higher than those in alone COPD group（P<0.05）.The most common comorbidities in patients of OVS group and alone COPD group were cardiovascular diseases（hypertension, arrhythmia, coronary heart disease） and diabetes.In different AHI groups, BMI, ODI and T90 increased with the increase of AHI, and the lowest SpO₂ decreases with the increase of AHI;The neck circumference of the high AHI group was higher than that of the other two groups, and the average SpO₂ was lower than that of the other two groups; The proportions of patients with FEV₁/FVC and ESS > 10 in high AHI group were higher than those in low AHI group（P<0.05）.The proportion of patients with ≥2 comorbidities in different AHI groups increased with the increase of AHI;The total number of diseases in moderate AHI group was higher than that in low AHI group; The proportion of patients with hypertension, pulmonary hypertension and the total number of diseases in the high AHI group were higher than those in the low AHI group（P<0.05）.Proportion of patients with hypertension, pulmonary hypertension, number of comorbidities ≥2 and total number of diseases in T90>20% group were significantly higher than those in T90≤20% group（P<0.001）.Conclusion Compared with patients with COPD alone, patients with OVS have a higher prevalence of co-morbidities.Prevalence of multiple co-morbidities is higher in OVS patients with AHI≥15 times/h and COPD patients with T90>20%.更多还原