Study Of Anticholinergics Treatment In Patients With Overlap Syndrome

[Objective]To find out new therapies for the treatment of OSAHS patients by curing these patients with moderate and severe obstructive sleep apnea and the patients with obstructive sleep apnea syndrome apnea syndrome in patients with chronic obstructive pulmonary disease (overlap syndrome) with tiotropium bromide, and observing the related data about before and after treatment for heart rate variability, pulmonary function, sleep monitoring, sleep score and others,and trying to find out the pathogenesis of obstructive sleep apnea syndrome, to explore the pathogenesis of patients with OS, appraising the efficacy of anticholinergics of OS and OSAHS patients in order to find out new therapies for the treatment of OS patients.[Methods]1.By means of the OSAHS patients with sleep apnea monitoring at night, defining diagnosis of the patients with obstructive sleep apnea syndrome; by way of pulmonary function in COPD patients with suspicious, defining diagnosis of COPD;2. For medium and severe OSAHS patients treated without and OS not line of M receptor blockers treatment in recently three months; tiotropium bromide powder inhaler treatment for a month, before treatment, evaluating the patients’general condition and Vital signs; measure24-hour holter monitor, night sleep apnea monitoring, detection and lung function, before and after therapy in24hours, appraising sleep scale of these patients before they sleeping and the after;3. Statistical processing:by SPSS statistical software, measuring data of the experiment data with mean+standard deviation, according to the comparison between the two sets of data selection two independent samples t test, multiple sets of data using analysis of variance of repeated measurement data.Count data using chi-square test.Level data using rank and inspection.To difference was statistically significant (P<0.05)。[Results]1. OSAHS and OS in patients with HF,LF/HF and pNN50significantly increased compared with the normal group(P<0.05), the OS patients, HF and pNN50are higher than OSAHS patients, and LF/HF is lower than the OSAHS patients OSAHS and OS in patients after treatment with tiotropium bromide powder inhaler, HF, pNN50after treatment than before treatment to some extent, and the LF/HF is higher than before treatment.difference have statistical significance;2. The OS patients, after treatment to the decrease in AHI,but OSAHS after treatment in patients with AHI has no obvious decrease;3. The OS and OSAHS patients’FEV1,FEV1%,and FEV1/FVC significantly decreased compared with the normal group (P<0.05), The OS patients, after treatment to the increase in FEV1,FEV1%,and FEV1/FVC,but OSAHS patients have no obvious increase after treatment;4. Sleep score results:patients with OS ESS、AIS and SSS score are lower after treatment; OSAHS patients’ score have no obvious drop, except SSS score;5. The lowest oxygen saturation during sleep in night:the OSAHS and OS patients decrease are lower compared with the normal, and the OS patients are decreased more; the OS patients’ lowest oxygen saturation in night increase after treatment, the OSAHS patients have no obvious increase after treatment; 6. AHI is related to LF/HF and pNN50in OSAHS patients.[Conclusion]1. In the process of OS develop, COPD and OSAHS supply each other, and have close relationship with cholinergic nervous tension increased;2. OSAHS patients and patients with OS, parasympathetic nervous tension increased compared with the normal,and OS patients’parasympathetic nervous tension are higher than OSAHS patients’;3. Tiotropium Bromide powder can reduce OS patients and patients with OSAHS parasympathetic nerve tension;4. After Tiotropium Bromide powder treatment, the OS patients’ clinical symptoms and sleep score are improved, with the fewer Ah1and higher the lowest oxygen saturation during sleep in night;5. The pathogenesis of sleep apnea may be associated with the parasympathetic nerve tension.