The Clinical Characteristics Of Chronic Obstructive Pulmonary Disease-Obstructive Sleep Apnea Syndrome Overlap Syndrome

Objective:Through the comparison of lung function,blood gas analysis,polysomnography and other indicators of COPD alone,OSA alone and OS,the differences between the three groups were analyzed,and to evaluate the effect when COPD coexisting with OSA,to investigate the difference of OS with unequal severity stage and different course.Methods:A retrospective case-control study was conducted to collect the clinical data of patients with COPD,OSA alone and OS alone in the Department of Respiratory Medicine,the First Hospital of Jilin University from January 2010 to October 2016.According to the apnea hypopnea index and pulmonary function,the patients were divided into COPD group(n = 27),OSA group(n = 21)and OS group(n = 22).And we collected the indexes of sex,age,duration of disease,body mass index,pulmonary function,parameters of polysomnography and blood gas analysis of patients,then to compare the general condition and the above indexes among three groups and to compare the differences between OS patients with different severity and different course,then to further evaluate the independent risk factors of COPA patients with OSA and OSA patients with COPD.Results:1.The age of OS group is significantly higher than it in OSA group,(P = 0.000).2.The smoker in OS group(68.2%)is more than COPD group(33.3%)(P = 0.015),patients with diabetes in OS group(40.9%)is more than COPD group(7.4%)(P = 0.005),patients with diabetes in OSA group(38.1%)is more than COPD group(7.4%)(P = 0.009).OS group(50.0%)have more cardiovascular diseases than patients with COPD(14.8%)(P = 0.009).The BMI of OS group is significant higher than it in the OSA group and COPD group,(P = 0.000).3.The FEV1% pred and FEV1 / FVC in the OS group and COPD group are more lower than that in the OSA group(P = 0.000).4.The AHI of OS group is significantly higher than that in COPD group and OSA group(P=0.000),the La SO2 of OS group is significantly lower than that in COPD group and OSA group(P = 0.000).The maximal oxygen reduction time at night of OS group was significantly higher than that of COPD group and OSA group(P =0.000).5.With the exacerbations of the condition,the AHI and BMI of OS group gradually increase,while the lowest night oxygen saturation gradually decrease,lung function damage is more serious,and AHI is positively correlated with BMI(r=0.858,P=0.000)and negative corelated with LSa O2(r=-0.686,P=0.000).6.With the extension of the course of disease,the AHI of OS patients gradually increase and the damage of the lung is more serious.7.The risk fator of COPD combined with OSA is BMI,and the risk factor of OSA combined with COPD is age.Conclusion:1.Compared to OSA group,OS group have more severe damage of pulmonary ventilation function,they are more easily combined with nocturnal hypoxemia and hypercapnia than OSA group and COPD group.2.COPD patients with higher BMI are more easily combined with OSA,OSA patients with higher age are more easily combined with COPD.