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1、阻塞性睡眠呼吸暂停综合征合并COPD的临床研究[摘要]目的：通过对OS患者的睡眠结构、肺功能、血气等进行分析，以提高对该病重视程度和诊治水平。方法：对20例OS、32例OSAS和51例COPD患者分别收集其一般临床资料，进行血气、肺功能、全夜PSG检查。结果：OS组的发病年龄、吸烟者比例、咳嗽咳痰、气促、紫绀、肺罗音比例均高于OSAS组，BMI、NC、夜间打鼾、夜间呼吸暂停、白天嗜睡的比例均高于COPD组；OS组合并心、肺、肾、脑等疾病的比例均高于OSAS组及COPD组；OS组的FVC、FEV1、FEV1/FVC、MVV、PaO2、SaO2的值均低于OSAS组，FRC、PaCO2均高于OSA
2、S组；OS组AHI与FEV1、FVC、MVV呈负相关，LSaO2与AHI呈负相关，LSaO2与FEV1、FVC、MVV呈正相关；OS组的最长呼吸暂停时间、S1+2、NREM均高于OSAS组，而LSaO2、REM均低于OSAS组，AHI、最长呼吸暂停时间、S1+2均高于COPD组，LSaO2、S3+4均低于COPD组。结论：OS患者既有COPD又有OSAS的临床症状及体征；结合身高、体重、NC等，对OSAS有筛检价值；对睡眠低氧血症明显的患者，应及时行PSG监测，确定是否合并OSAS；改善OS患者的肺功能、气道功能，提高患者的肺容量以减少睡眠呼吸紊乱的发生，纠正夜间低氧血症是治疗OS的重要手段
3、之一。[关键词]重叠综合征；慢性阻塞性肺疾病；睡眠呼吸暂停综合征；多导睡眠图；睡眠结构[Abstract]Objective：：Toevaluatethechangesofsleepstructure,pulmonaryfunction,bloodgasanalysisofoverlapsyndrome(OS),weanalysistheclinicalcharacteristics,bloodgasanalysis,pulmonaryfunctionandnocturnalpolysomnography(PSG)inthepatientswithchronicobstructivepulm
4、onarydisease(COPD),obstructivesleepapneasyndrome(OSAS)oroverlapsyndrome(OS).Methods：20patientswithOS,32withOSASand51withCOPDweremonitoredanddiagnosedbynocturnalPSG,bloodgasanalysis,pulmonaryfunctionandclinicalcharacteristics.Results:Theageofonset,theproportionofsmoke,theproportionofcough,expectorat
5、ion,polypnea,cyanosis,rhonchiandmoistraleintwolungswerehigherinOSpatientsthanOSASgroup,thelevelofbodymassindex(BMI),neckcircumference(NC),theproportionofpolypnea,nighttimesnore,nighttimeapnea,daytimehypersomnolencewerehigherinOSpatientsthanCOPDgroup,theproportionofheart、pulmonary、kidney、encephalopa
6、thywerehigherinOSpatientsthanOSASgroupandCOPDgroup,FVC,FEV1,FEV1/FVC,MVV,PaO2,SaO2werelowerinOSpatientsthanOSASgroup,FRC,PaCO2werehigherinOSpatientsthanOSASgroup,AHIwasinverselyrelatedtotheFEV1,FVC,MVVinGroupOS,LSaO2inGroupOSwasinverselyrelatedtotheAHI.andtheLSaO2waspositivelyrelatedtotheFEV1,FVC,M
7、VVinGroupOS;thelongesttimeofsleepapnea,S1+2,NREMwerehigherinOSpatientsthanOSASgroup,LSaO2,S3+4werelowerinOSpatientsthanCOPDgroup.Conclusions：OSpatientshadnotonlythe7symptomsandsignsofCOPD,butalsothoseofOSAS
