| BackgroundChronic obstructive pulmonary disease(COPD)and obstructive sleep apnea hypopnea syndrom(OSAHS)are common respiratory system diseases,as a result of both common and multiple,a good chance of occurring at the same time in the same patients,both coexist is also known as Overlap Syndrome(Overlap Syndrome OS),a large number of research shows that OSAHS closely associated with COPD,mutual influence,causal,on the one hand,after merger of OSAHS COPD,participate in the development of COPD,which aggravate the lung function damage,On the other hand,COPD can also aggravate the development of OSAHS.Overlap syndrome will have more severe sleep-related hypoxemia than OSAHS or COPD alone.COPD,OSAHS disease ischemia hypoxia increases the risk of osteoporosis,fractures and other complications caused by osteoporosis seriously affect the patient’s quality of life,so through the merger of OSAHS patients with COPD clinical observation and understanding of COPD combined osteoporosis occurs in patients with OSAHS and influencing factors,prevention of elderly people in the future,especially in patients with COPD combined OSAHS osteoporosis prevention has important clinical value.ObjectiveThrough clinical observation of patients with COPD combined with OSAHS and comparison with patients with COPD alone,to investigate the occurrence and risk factors of osteoporosis in patients with chronic obstructive pulmonary disease(COPD)and Obstructive Sleep Apnea-hypopnea Syndrome(OSAHS).MethodThe clinical data of 183 patients with COPD and OSAHS who were hospitalized in our hospital from September 2017 to June 2019 were selected for study.According to the results of bone mineral density examination,T≤-2.5 was used as the criteria for osteoporosis.The patients included in the study were divided into osteoporosis group and non-osteoporosis group,and the incidence of osteoporosis in patients with COPD and OSAHS was calculated.Through medical records and questionnaires,patient-related clinical data were collected to analyze the independent influencing factors of osteoporosis in patients with COPD and OSAHS.200 patients with simple COPD were selected as the control group in the same period.According to the pulmonary function,the two groups were divided into four subgroups: mild,moderate,severe and extremely severe.The incidence of osteoporosis was compared between the groups.ResultA total of 183 patients with COPD and OSAHS were enrolled in this study,42(22.96%),78(42.62%)with osteopenia,and 63(34.42%)with osteoporosis.The age,body mass index,COPD duration,and OSAHS duration of the patients in the osteoporosis group were significantly higher than those in the non-osteoporosis group.The patients with a history of drinking were significantly more than those without osteoporosis,and the difference was statistically significant(P<0.05).The severity of COPD in patients with osteoporosis was significantly higher than that in patients without osteoporosis,and the difference was statistically significant(P<0.05).The severity of OSAHS in patients with osteoporosis was significantly higher than that in patients without osteoporosis,and the difference was statistically significant(P<0.05).The levels of FVC,FEV1,and FEV1/FVC in the osteoporosis group were lower than those in the non-osteoporosis group,and the difference was AQW·1statistically significant(P<0.05).Patients with osteoporosis had a higher history of glucocorticoid use than those without osteoporosis.Home oxygen therapy,home ventilator,and exercise were significantly lower than those without osteoporosis.The difference was statistically significant(P <0.05).The oxygen saturation of the patients in the osteoporosis group was lower than that in the non-osteoporosis group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed age(OR=6.214,P=0.001),body mass index(OR=4.514,P=0.015),drinking history(OR=5.554,P=0.006),and COPD condition(OR=3.657,P=0.031),OSAHS condition(OR=3.941,P=0.029),FEV1/FVC level(OR=4.214,P=0.021),history of glucocorticoid use(OR =5.558,P=0.006),Blood oxygen saturation(OR=2.556,P=0.039)was an independent influencing factor for osteoporosis in patients with COPD combined with OSAHS;home oxygen therapy(OR=-4.614,P=0.020),home use ventilator(OR=-5.164,P=0.007),exercise Good(OR=-5.944,P=0.004)was a protective factor for osteoporosis in patients with COPD combined with OSAHS.The incidence of osteoporosis in the mild,moderate,severe,and severe groups was higher in the study group than in the control group(17.65% vs.4.35%,35.21% vs.11.36%,43.90% vs.12.24%,55.00% vs.17.65%,P <0.05).ConclusionThe incidence of osteoporosis is higher in COPD patients with OSAHS than in simple COPD patients.The factors affecting the risk of osteoporosis in patients with COPD and OSAHS come from different aspects,including patient age,body mass index,drinking history,COPD and OSAHS severity,and lung function,history of glucocorticoid use,Blood oxygen saturation,etc.,while home oxygen therapy,home ventilator and good exercise can reduce the risk of osteoporosis in patients with COPD and OSAHS.In clinical practice,relevant management factors and protective factors are intensified to strengthen the management and prognosis of patients with COPD combined with OSAHS,all of which have important value in delaying the loss of bone mass and reducing the risk of osteoporosis. |
