The relevance between obstructive sleep apnea hypopnea syndrome and chronic obstructive pulmonary disease in China:A Meta-analysis
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摘要: 目的:系统评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与慢性阻塞性肺病(COPD)之间的相关性。方法:计算机检索Cochrane Library、中国生物医学文献数据库、PubMed、中国学术期刊全文数据库(CNKI)、万方资源数据库、重庆维普网等电子数据库,查找OSAHS与COPD相关性的病例对照研究,并手工检索相关会议文献及未公开发表的相关文章。对符合条件的随机对照试验,逐一按文献评价标准对文献质量进行评价,并提取相关数据,采用RevMan5.3软件进行Meta分析。结果:共纳入19个病例对照研究,Meta分析结果显示:重叠综合征(OS)患者AHI显著高于单纯OSAHS患者,差异有统计学意义[WMD=7.56,95%CI(4.19,10.94),P<0.01];OS患者较单纯OSAHS患者的LSaO2显著偏低,差异亦有统计学意义[WMD=-10.50,95%CI(-11.58,-6.08),P<0.01];OS患者一秒钟用力呼气容积占用力肺活量百分比(FEV1/FVC)显著低于COPD患者,差异有统计学意义[WMD=4.65,95%CI(1.15,8.15),P<0.01];OS患者与OSAHS患者AHI在样本量、年龄、BMI、FEV1/FVC指标亚组分析存在异质性,在ESS评分指标亚组分析不存在异质性;OS患者与COPD患者的FEV1/FVC指标在样本量、BMI、AHI、LSaO2、T90亚组分析存在异质性,颈围亚组分析不存在异质性;漏斗图基本对称,提示可能存在一定的发表偏倚。结论:OSAHS与COPD之间存在显著相关性,可能互为危险因素。Abstract: Objective:To assess the correlation between obstructive sleep apnea hypopnea syndrome(OSAHS) and chronic obstructive pulmonary disease(COPD).Method:Databases such as Chinese Biomedical Literature Database, PubMed, Chinese Academic Journals full-text database, Wanfang Resource Database and Chongqing VIP have been searched to collect literatures about the relationship between OSAHS and COPD. The literature in conference proceedings and certain unpublished articles were also manually retrieved. RCT conformed to the condition was evaluated according to the standards of literature assessment, and the data has been extracted. The RevMan5.3 software was applied to carry out the same Meta-analysis.Result:Totally 19 articles were included, and Meta-analysis reveal that overlap syndrome(OS) patient's apnea hypopnea index is significantly higher than those of OSAHS patients[WMD=7.56, 95%CI(4.19,10.94),P<0.01]; The LSaO2 of OS patients is significantly lower than OSAHS patients[WMD=-10.50, 95%CI(-11.58, -6.08),P<0.01]; OS patients' FEV1/FVC is significantly lower than COPD patients[WMD=4.65,95%CI(1.15,8.15),P<0.01]. The results revealed that subgroup analysis according to the sample volume, age, body mass index(BMI) and FEV1/FVC between OS patients and OSAHS patients has heterogeneity, but when analysis with the score of ESS the heterogeneity does not exist. Further, the subgroup analysis according to the sample volume, BMI, AHI,LSaO2 and the time of Oxygen is lower than 90%(T90) those index between OS patients and COPD patients has heterogeneity, and the heterogeneity does not exist when subgroup is analyses with neck circumference. The funnel schema was nearly symmetry with little bias.Conclusion:The experimental results indicate that OSAHS is significantly related with COPD, and they may be the mutual risk factor for each other.
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