【摘要】 目的分析阻塞性睡眠呼吸暂停低通气综合症（OSAHS）合并慢性阻塞性肺疾病（COPD）的重叠综合征（OS）患者的肺功能及睡眠结构的差异;评价双水平气道正压通气治疗OS患者的疗效。方法选取2017年1月至2018年6月就诊于本院呼吸科患者200例,进行肺功能检查、夜间多导睡眠（PSG）监测。按照PSG及肺功能检查将其分为OS组（COPD合并OSAHS）、COPD组、OSAHS组、对照组,检测血清C反应蛋白（CRP）、超氧化物歧化酶（SOD）指标,记录呼吸暂停低通气指数（AHI）、最长呼吸暂停时间（LAT）、最低脉氧饱和度（LSaO₂）、平均脉氧饱和度（MSaO₂）、FEV1%、FEV1/FVC%。对OS组、OSAHS组患者进行双水平气道正压通气治疗1个月后,再次进行肺功能及多导睡眠监测,行CRP、SOD的检测,比较FEV%、FEV/FVC%、AHI、LAT、LSaO₂、MSaO₂、CRP、SOD等指标。结果 4组患者中,OS组的AHI、LAT、CRP均高于其他组,差异有统计学意义（P<0.05）,而LSaO₂、MSaO₂、FEV1%、FEV1/FVC%均低于其他组,差异有统计学意义（P<0.05）,OS组的SOD低于对照组,差异有统计学意义（P<0.05）。双水平气道正压通气治疗后,OS组的AHI、LAT、CRP较治疗前明显降低,LSaO₂、MSaO₂、FEV₁%、FEV₁/FVC%、SOD较治疗前明显升高,差异有统计学意义（P<0.05）。结论双水平气道正压通气治疗可明显改善OS患者的睡眠及肺功能,降低炎症反应,改善氧化应激反应。更多还原

【Abstract】 Objective To analyze the differences of pulmonary function and sleep structure in patients with OSAHS combined with chronic obstructive pulmonary disease（COPD）.To evaluate the efficacy of dual level positive airway pressure ventilation in the treatment of OS patients.Methods A total of 200 patients admitted to the respiratory department in our hospital from January 2017 to June 2018 were selected for pulmonary function tests and night polysomnography（PSG） monitoring.According to PSG and pulmonary function examination,they were divided into OS group（COPD with OSAHS）,COPD group,OSAHS group and control group.Serum（C-reactive protein,CRP）,superoxide dismutase（SOD） indexes were detected,and apnea hypoventilation index（AHI）,longest apnea time（LAT）,lowest pulse oxygen saturation（LSaO₂）,average pulse oxygen saturation（MSaO₂）,FEV₁%,FEV₁/FVC% were recorded.After 1 month of double-level positive airway pressure ventilation for patients in OS group and OSAHS group,the pulmonary function and polysomnography were monitored again,and CRP and SOD were detected,and the indexes such as FEV₁%,FEV₁/FVC%,Am,LAT,LSaO₂,MSaO₂,CRP and SOD were compared.Results Four groups of patients,AHI,LAT,CRP in OS group were higher than that of other groups,the difference were statistically significant（P<0.05）,while LSaO₂,MSaO,FEV1%,FEV1/FVC% are lower than other groups,the difference was statistically significant（P<0.05）,the double level positive airway pressure therapy,the OS group AHI,LAT,CRP was significantly decreased,the LSaO₂,MSaO,FEV₁%,FEV₁/FVC%,SOD was increased significantly,the difference was statistically significant（P<0.05）.Conclusion Double-level positive airway pressure ventilation can significantly improve sleep and lung function in OS patients,reduce inflammatory response,and improve oxidative stress response.更多还原