重叠综合征与肺血栓栓塞症发病率的横断面调查

doi:10.3969/j.issn.1006-7795.2018.02.023

摘要/Abstract

摘要： 目的调查重叠综合征是否与肺血栓栓塞症（pulmonary embolism，PE）发病率相关。方法回顾2011年1月至2014年12月在首都医科大学附属北京安贞医院接受睡眠监测的1 939名患者。重叠综合征的诊断标准为临床诊断慢性阻塞性肺疾病并且夜间睡眠呼吸暂停低通气指数（apnea-hypopnea index，AHI）≥ 5/h。使用Logistic回归模型分析PE发病的相关危险因素。结果矫正年龄、体质量指数、AHI、睡眠平均氧饱和度（meanSaO₂）、高血压、糖尿病后，重叠综合征患者比非重叠综合征患者发生PE的概率高（OR 3.78，95%CI 1.28~9.82，P=0.018）。亚组分析显示，在男性患者中，重叠综合征与PE的发病高度相关（OR 5.16，95%CI 1.21~36.01，P=0.025）。多重Logistic回归模型中，meanSaO₂低于总体人群中位数（93%）与PE发病概率增加相关（OR 2.82，95%CI 1.27~6.61，P=0.011）。结论重叠综合征与PE发病存在相关性，需要有进一步的研究关注治疗重叠综合征是否降低栓塞性疾病的风险。

关键词: 重叠综合征, 肺血栓栓塞症, 慢性阻塞性肺疾病, 睡眠呼吸暂停

Abstract: Objective To investigate the association between overlap syndrome and prevalence of pulmonary embolism (PE). Methods Totally 1 939 patients who completed sleep test from January 2011 to December 2014 in Beijing Anzhen Hospital, Capital Medical University were retrospectively studied. Overlap syndrome were defined as simultaneous diagnosis of chronic obstructive pulmonary diseases and obstructive sleep apnea[apnea-hypopnea index (AHI) ≥ 5/h]. Logistic analysis was used to evaluate the association of overlap syndrome with PE. Results Patients with versus those without overlap syndrome had higher odds of PE after adjusting for age, body mass index, AHI, meanSaO₂, hypertension, diabetes (OR 3.78, 95%CI 1.28-9.82, P=0.018). Overlap syndrome was associated with PE prevalence only among male subjects (OR 5.16, 95%CI 1.21-36.01, P=0.025). In multiple Logistic model, patients with meanSaO₂<93% (the median value of all subjects) had higher odds of PE than those with meanSaO₂ ≥ 93% (OR 2.82, 95%CI 1.27-6.61, P=0.011). Conclusion Overlap syndrome is associated with high prevalence of PE. Further study is needed to verify whether treatment toward overlap syndrome may reduce the risk of thrombotic diseases.

Key words: overlap syndrome, pulmonary embolism, chronic obstructive pulmonary disease, obstructive sleep apnea

中图分类号:

谢江, 李菲. 重叠综合征与肺血栓栓塞症发病率的横断面调查[J]. 首都医科大学学报, 2018, 39(2): 282-285.

Xie Jiang, Li Fei. Association of overlap syndrome with pulmonary embolism in a cross-sectional study[J]. Journal of Capital Medical University, 2018, 39(2): 282-285.

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