摘要
目的 通过对肺移植术后患者的临床资料的回顾性分析,探索肺移植术后患者发生阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的危险因素.方法 收集2020年1月1日-2022年1月1日27例在无锡市人民医院行肺移植手术后发生OSA患者的临床资料,同时收集28例肺移植手术后未发生OSA患者的临床资料,对移植术后＞1个月临床稳定的患者进行多导睡眠监测,根据呼吸暂停-低通气指数(apnea-hypopnea index,AHI),分为OSA组(AHI≥5次/h)和非OSA组(AHI＜5次/h),分析两组患者的观察指标是否有差异,进行单因素和多因素Logisit回归分析.结果 OSA组在体重指数(body mass index,BMI)[(23.7±1.6)kg/m2 比(21.3±0.9)kg/m2,P=0.008]、颈围[(38.8±1.6)cm 比(36.0±1.9)cm,P=0.019]和移植前患慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)和特发性肺间质纤维化(idiopathic pulmonary fibrosis,IPF)(88.9％比 60.9％,P=0.038)显著高于非 OSA 组.单因素 Logisit 回归分析显示,BMI(OR=1.263,95％CI=1.051～1.517,P=0.013)、颈围(OR=1.180,95％CI=1.014～1.374,P=0.032)和移植前COPD/IPF与其他肺部疾病的比(OR=8.088,95％CI=1.588～41.189,P=0.012)为危险因素.多因素Logisit回归分析显示,移植前COPD/IPF与其他肺部疾病的比(OR=5.784,95％CI=1.047～31.963,P=0.044)为独立危险因素.结论 BMI、颈围、和移植前COPD是移植术后患者患OSA的危险因素,其中移植前COPD是OSA的独立危险因素.
Abstract
Objective A retrospective analysis of clinical data was performed to uncover risk factors for obstructive sleep apnea(OSA)in patients after lung transplantation.Methods From January 1,2020 to January 1,2022,the clinical data of 27 patients with OSA as well as 28 patients without OSA after lung transplantation in Wuxi People's Hospital were collected.Polysomnography(PSG)was performed in clinically stable patients＞1 month after transplantation,according to the apnea-hypopnea index(AHI)=5 events/h,ithe patients were divided into OSA group(AHI≥5 events/h)and non-OSA group(AHI＜5 events/h).The differences in observation indicators between the two groups were analyzed,and univariate and multivariate logisit regression analysis was performed.Results The body mass index(BMI)、neck circumference and ratio of pre-transplant COPD/IPF to other lung diseases of the OSA group were significantly higher than those in the non-OSA group.Univariate logistic regression analysis showed BMI(OR=1.263,95％CI=1.051～1.517,P=0.013),neck circumference(OR=1.180,95％CI=1.014～1.374,P=0.032),and the ratio of pre-transplant COPD/IPF to other lung diseases(OR=8.088,95％CI=1.588～41.189,P=0.012)as risk factors.Multivariate logistic regression analysis showed that the ratio of pre-transplant COPD/IPF to other lung diseases(OR=5.784,95％CI=1.047～31.963,P=0.044)was an independent risk factor.Conclusion BMI,neck circumference,and pre-transplant COPD were risk factors for OSA in post-transplant patients,and pre-transplant COPD was an independent risk factor for OSA.
维普
万方数据