Study On The Clinical Characteristics Of OSAHS Combined With Obesity Hypopnea Syndrome

Objective: With the improvement of living standard,obesity is more and more common in people of all ages,resulting in many obesity-related diseases.Obstructive sleep apnea-hypopnea syndrome(OSAHS)and obesity hypopnea syndrome(OHS)are two common respiratory diseases,which are related to obesity and other factors.Although they are two different diseases,OSAHS and OHS are often combined in clinical practice.Such patients tend to be sicker,have more complications and have higher mortality.But the diagnosis and treatment of OHS is often neglected.This paper mainly studies the clinical characteristics,diagnostic indicators and therapeutic effects of OSAHS patients with OHS.Research contents and methods: Choose patients from respiratory medicine sleep center of Tianjin Medical University General Hospital who have completed overnight polysomnography(PSG)between January 2018 and October 2019,1507 patients with diagnosis of OSAHS excluded according to the inclusion criteria and exclusion criteria selection,choose the OSAHS patients 100 cases,divided into pure OSAHS group and OSAHS combined OHS,43 patients with OSAHS alone among them,57 patients with OSAHS combined OHS,between the ages of 18 and 70 years old.Record the two groups of patients’ age,gender,height,weight,body mass index(BMI),neck circumference,waist circumference,blood pressure,medical history,physical examination(including nasal cavity,maxillofacial anatomy and pharynx),sleepiness scores,day and night clinical manifestation,pulmonary function,arterial blood gas analysis examination,thyroid function examination,electrocardiogram,and apnea hypoventilation index,oxygen reduction index arousal index(Ar I),total sleep time(TST),REM sleep duration,duration,duration of N1,N2,N3 period duration,number of REM sleep apnea,REM sleep AHI,REM at low frequency,REM apnea duration,NREM stage apnea times,NREM stage apnea duration,average blood oxygen saturation(Sp O2),the lowest oxygen saturation,supine AHI,average heart rate,maximum heart rate,blood oxygen saturation was less than 90% of the time percentage(T90 %),mechanical ventilation pressure titration mode and etc.By analyzing and comparing the clinical data of the two groups of patients,the correlation and difference in diagnosis and treatment between OSAHS combined with OHS and OSAHS alone were discussed.Results :(1)There was no statistically significant difference in age,sex and BMI between the OSAHS group and the OSAHS group combined with OHS(P > 0.05),and the differences in neck circumference and waist circumference were statistically significant(P < 0.05).(2)The differences in p H value,Pa CO2,Pa O2 and fev1% and FVC% of the pulmonary function examination were statistically significant(P < 0.05),while the differences between FEV1/FVC,MMEF50 and DLCO were not statistically significant.(3)In patients with OSAHS group and pure OHS merger OSAHS patients during REM sleep duration,sleep duration period of N3,average heart rate,blood oxygen saturation is lower than 90% of the time the percentage of the total sleep time(T90 %)differences statistically significant(P < 0.05),suggesting OHS merger in patients with OSAHS in deep sleep less proportion in the time of sleep,or difficult to enter a state of deep sleep,REM sleep apnea degree aggravating,night sleep during anoxia time longer.There was no significant difference in other indicators(P > 0.05).(4)Through the analysis of positive airway pressure ventilation mode and PSG indexes before and after treatment in the two groups,CPAP and BPAP modes have a significant therapeutic effect on patients with OSAHS alone and OSAHS combined with OHS.There was no significant difference in the therapeutic effect of CPAP and BPAP modes determined by pressure titration on patients(P > 0.05),but the BPAP mode was more suitable for patients with OSAHS combined with OHS and higher pco2 at night.Conclusion: OSAHS patients with OHS have many differences from OSAHS patients in terms of neck circumference,waist circumference,arterial blood gas analysis,pulmonary function examination,PSG examination results and treatment methods.Clinical vigilance against these indicators and routine pulmonary function and arterial blood gas analysis in OSAHS patients are conducive to early detection of OHS.Early diagnosis and treatment are important for improving the quality of life and reducing mortality in these patients.