天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (7): 753-757.doi: 10.11958/j.issn.0253-9896.2015.07.014

• 临床研究 • 上一篇    下一篇

慢性阻塞性肺病与重叠综合征患者肺功能的比较

李群，王彦，曹洁，周宁，王杰，郭美南   

  1. 1. 天津医科大学总医院
    2. 天津医科大学总医院呼吸科
    3. 天津医大总医院呼吸科
  • 收稿日期:2014-11-07 修回日期:2015-02-27 出版日期:2015-07-15 发布日期:2015-07-15
  • 通讯作者: 李群 E-mail:836205283@qq.com
  • 基金资助:
    国家十二五科技支撑计划课题资助（2012BAI05B02）

Comparison of pulmonary function between chronic obstructive pulmonary disease and overlap syndrome in patients

LI Qun, WANG Yan, CAO Jie, ZHOU Ning, WANG Jie， GUO Meinan   

  1. Department of Respiratory Medicine, General Hospital of Tianjin Medical University, Tianjin 300052, China

  • Received:2014-11-07 Revised:2015-02-27 Published:2015-07-15 Online:2015-07-15
  • Contact: qun li E-mail:836205283@qq.com

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摘要： 摘要 目的 比较单纯慢性阻塞性肺病(慢阻肺)与重叠综合征（overlap syndrome，OS）患者的肺通气功能与气道阻力。方法 纳入2012年10月~2014年8月就诊于天津医科大学总医院呼吸科患者194例，均经询问病史、日间肺功能检查及夜间多导睡眠（Polysomnography, PSG）监测，根据PSG及肺功能检查结果将其分为OS组78例，慢阻肺组76例，健康对照组40例。分别比较3组受试者肺通气功能指标以及脉冲振荡肺功能指标。结果 肺通气功能指标中，OS组与慢阻肺组比较呼气峰流速（peak expiratory flow，PEF）、剩余75%用力肺活量时呼气流速（maximal expiratory flow after 75% of the FVC has not been exhaled，MEF75）显著降低。其中OS（AHI≥30次/h）患者与慢阻肺组比较，除了PEF、MEF75显著降低之外，剩余25%用力肺活量时呼气流速（maximal expiratory flow after 25% of the FVC has not been exhaled，MEF25）、最大呼气中期流量（maximal mid-expiratory flow，MMEF）也明显降低。脉冲振荡肺功能指标中，OS组与慢阻肺组比较，呼吸总阻抗（Zrs）、振荡频率为5HZ时的黏性阻力（R5）、振荡频率为20HZ时的黏性阻力（R20）、共振频率（Fres）显著增加， OS（AHI≥30次/h）患者较慢阻肺组除了Zrs、R5、R20、Fres显著增加外，R5与R20的差值（R5-R20）、振荡频率为5HZ时的弹性阻力（X5）也有显著差异。结论 OS比慢阻肺患者气道阻塞严重，且重度睡眠呼吸紊乱可以加重慢阻肺患者的小气道阻塞。

Abstract: Abstract: Objective To explore the difference in pulmonary function between overlap syndrome and chronic obstructive
pulmonary disease (COPD) in patients. Methods One-hundred-ninty-four patients came from respiratory department in Tianjin
Medical University General Hospital, from October 2012 to August 2014, were included in this study. After inquisition of medical
history, evaluation of lung function and polysomnography (PSG), patients were divided into overlap syndrome (OS, n=78) group,
COPD group (n=76) and healthy control group (n=40). The indexes of lung function and the pulse oscillation index of pulmonary
function were compared between three groups. Results Values of the peak expiratory flow rate (PEF) and the remaining 75%
FVC when expiratory flow rate (MEF75) were significantly decreased in OS group than those of COPD group (P＜ 0.05). Patients
with sleep apnea hypopnea index (AHI) ≥30 times/h showed significantly decreased MEF25 and the maximum mid expiratory
flow (MMEF) in OS group than those of COPD group (P＜ 0.05). Values of the total impedance (Zrs), the resonant frequency (Fres),
viscosity resistance when oscillation frequency was 5 Hz (R5), R20 were significantly increased in OS group than those of COPD
group (P＜ 0.05). Patients with AHI ≥30 times/h were increased significantly than COPD group in R5-R20 and X5 besides Zrs,
Fres, R5, R20. Conclusion There is more serious airway obstruction in patients with OS than that in patients with COPD. Severe
sleep disordered breathing can aggravate small airway obstruction in patients with COPD

Key words: pulmonary disease, chronic obstructive｜ sleep apnea, obstructive｜ respiratory function tests, airway resis
tance,  overlap syndrome
pulmonary disease, chronic obstructive, sleep apnea, obstructive, respiratory function tests, airway resis
tance, overlap syndrome