The Clinical Observation Of COPD And OSAHS

Introduction：OSAHS and COPD were two common pulmonary diseases that often coexistedwith an individual which was known as Overlap Syndrome. Large amount of researchshowed that COPD and OSAHS could influence each other to a certain extent. On oneside OSAHS could accelerate the decline of the pulmonary function on COPD patients,on the other side, COPD ccould also aggravation the developing of OSAHS. Numerousstudies found that this overlap might cause more severe nocturnal hypoxemia,pulmonary hypertension, and chronic pulmonary heart disease than either disease alone.Noninvasive mechanical ventilation was the preferred method. Therefore it was quiteimportant to understand the disease。Objective：To investigate the risk factors and find out the evidence for combination of COPDand OSAHS. Comparing the comorbidity of COPD group and OS group, research theinfluence on important organs. Through Comparing with the arterial blood gas analysis,PSG and pulmonary function test of the two groups, to find out the changes of thepulmonary function and sleep structure of the OS patients. By contrasting the arterialblood gas analysis and the main respiratory parameters of before and after NIPPVtreatment, to explore the application of non-invasive iventilation in OS patients.Methods：Screening the807AECOPD patients who were in hospital from May2012toJanuary2014, and we chose the complete data which concluded the arterial blood gasanalysis, PSG and pulmonary function test of55patients. We divided the patients intotwo group named COPD group and OS group. Pulmonary function(FEV1,FEV1/FVC),arterial blood gas analysis before and after NIPPV treatment(pH、PaO2、PaCO2、HCO3-、SaO2),PSG(AHI,RDI) and comorbidity were measured and analyzed. Results：(1)The BMI of OS patients was higher than that of COPD patients,(P<0.05), andthe proportion of hypertension, coronary heart disease, cerebrovascular diseases in OSpatients was more than COPD patients, the difference shows statistical significance(P<0.05).(2)PSG: The AHI and RDI of OS patients were significant higher than that ofCOPD patients (P<0.05).(3) Pulmonary function: The FEV1%, FEV1/FVC%of OS patients was lower thanthat of COPD patients (P<0.05).(4) Arterial blood gas analysis: The level of PaO2, SaO2of OS patients was lowerthan COPD patients, and the level of HCO3-and PaCO2was higher than that of COPDpatients (P<0.05).(5)After NIPPV treatment, the arterial blood gas analysis (pH SaO2.PaO2、HCO3-、PaCO2) of the two group were improved, compared with no treatment(P<0.05). Butcontrasting to COPD patients, the level of EPAP of OS patients was higher(P<0.05).Conclusion：Hypoxemia and hypercapnia in the OS group were more obvious than that inCOPD group. The pulmonary function injury in the OS group was more serious thanthat in COPD group. The OS patients had more risk of combination with hypertension,coronary heart disease and cerebrovascular disease than COPD patients. Obese patientswith COPD should be more attention in overlapping OSAHS. Therefore,polysomnography(PSG) was necessary for those patients. NIPPV was the best choice toimprove hypoxia situation.