Clinical study in elderly patients with chronic obstructive pulmonary disease and obstructive sleep apnea hypopnea syndrome

doi:10.3969/.issn.1674-3245.2018.01.006

Abstract：Objective To investigate the clinical characteristics of overlap syndrome(OS), that is chronic obstructive pulmonary disease(COPD)combined with obstructive sleep apnea hypopnea syndrome(OSAHS)in elderly patients. To provide information and evidence for the diagnosis and treatment of OS. Methods The neck circumference,body mass index(BMI), polysomnography,static lung function,blood gas analysis and echocardiography were measured in 55 COPD patients and 32 OS patients. There was no statistical difference in sex ratio and age between the COPD group and the OS group(P> 0.05). Results The neck circumference and BMI in OS were significantly higher than those in COPD group(P<0.05).In OS group,the percent of the total recorded time spent below 90% oxygen saturation(Ts90%)and pulmonary arterial systolic pressure(PASP)were significantly higher than those in COPD group(P< 0.05),the apnea hypopnea index(AHI)and the longest apnea time(LAT)were significantly higher than those in COPD group(P < 0.01). The lowest nocturnal oxygen saturation(LSaO2),mean nocturnal oxygen saturation (MSaO2),oxygen saturation(SaO2),oxygen partial pressure(PaO2),forced expiratory volume in one second to forced vital capacity ratio(FEV1%)and FEV1/forced vital capacity(FEV1/FVC)were significantly lower in OS group than those in COPD group(P<0.05).There was no significant difference in PaCO2between the two groups.The prevalence of pulmonary hypertension(PASP≥ 40 mmHg)was 46.9% in OS group(15/32)and 7.3% in COPD group(4/55).The prevalence of pulmonary hypertensionwere significantly higher in OS group(P < 0.01). Conclusion Obese patients are more likely to suffer from OS. In OS patients,hypoxemia,sleep quality,lung function decline are more severe than in COPD patients. Patients with OS are more prone to pulmonary arterial hypertension.