【摘要】 目的探讨阻塞性睡眠呼吸暂停(OSA)与慢性呼吸系统疾病(CRDs)交互作用可能的病理生理机制,对比评价致纤维化型间质性肺疾病(ILD)和慢性阻塞性肺疾病(COPD)患者中OSA的发生情况和严重程度。方法选择2015年9月至2018年12月于中日友好医院呼吸与危重症医学科诊断的73例COPD患者和77例致纤维化型ILD患者,进行多导睡眠监测、肺功能检查和其他临床评估。OSA定义为睡眠呼吸暂停低通气指数(AHI)≥5次/h。结果不依赖于年龄、性别、体质指数(BMI)、白日嗜睡程度及并发症情况,致纤维化型ILD患者较COPD患者发生中、重度OSA更为常见(61%vs. 44%, P=0.02),程度更为严重[AHI(22.4±16.5)次/h vs.(16.8±13.2)次/h, P=0.02]。OSA的严重程度(AHI)与COPD和ILD患者的用力肺活量、肺总量及弥散功能无关。结论 OSA常见于慢性呼吸系统疾病患者,与COPD相比,致纤维化型ILD患者的OSA更为常见,程度更为严重;静态肺功能指标与慢性呼吸系统疾病患者OSA的严重程度无关。提示有必要开展ILD疾病特异性的OSA的临床研究及治疗方式探讨。更多还原

【Abstract】 Objective To investigate the pathophysiological interactions between obstructive sleep apnea(OSA)between chronic respiratory diseases(CRDs)and to compare the prevalence and severity of OSA between fibrotic interstitial lung disease(ILD)and chronic obstructive pulmonary disease(COPD). Methods Seventy-three patients with COPD and 77 patients with fibrotic ILD were studied in this prospective investigation from September 2015 to December 2018. A full polysomnogram(PSG), pulmonary function testing and other clinical evaluations were performed. OSA was defined as an apnoea–hypopnoea index(AHI)≥5 events/h of sleep. Results OSA was more common(61% vs.44%, P = 0.02)and more severe[AHI(22.4 ± 16.5)/h vs.(16.8 ± 13.2)/h, P = 0.02] in patients with fibrotic ILD compared to COPD patients,independent of age, gender, body mass index, Epworth Sleepiness Scale, and comorbidities. There was no relationship between AHI and forced vital capacity(FVC), total lung capacity(TLC)or diffusion capacity for carbon monoxide(DLco)in both patients with COPD and ILD. Conclusion OSA is common in CRDs. OSA is more frequent and more severe in patients with fibrotic ILD than in COPD. These findings suggest the need for disease-specific studies to evaluate the potential utility of ambulatory oxygen in fibrotic ILD.更多还原