Связь системного воспаления с тяжестью обструктивного апноэ сна у мужчин пожилого возраста с хронической обструктивной болезнью легких

Abstract

The combination of obstructive sleep apnea syndrome (OSA) and chronic obstructive pulmonary disease (COPD) is characterized by deep nocturnal hypoxemia and a higher risk of pulmonary hypertension. The study of the participation of blood cellular elements and indices of cellular reactivity in the inflammatory response in this comorbidity is relevant today. The purpose was to study the severity of systemic inflammation in elderly patients with chronic obstructive pulmonary disease depending on the obstructive sleep apnea syndrome severity. We examined 126 men (aged 67.3 ± 3.4 years) diagnosed with COPD 1–2 low risk of exacerbations. Depending on the presence of OSA, the patients were divided into 2 groups: group 1 — 32 people without OSA, group 2 — 94 people with OSA. Symptoms were assessed using the modified Medical Research Council (mMRC) dyspnea scale and the COPD assessment test (CAT). The severity of OSA syndrome was assessed by the frequency of respiratory events: mild – from 5 to 15 per hour; moderate — from 15 to 30 per hour; severe — more than 30 per hour. The indices were calculated: quantitative ratio of neutrophils (N) and lymphocytes (L) — NLR = N/L; ratio of platelets (P) to lymphocytes PLR = P/L, systemic inflammatory index (SII) = platelet × neutrophils / lymphocytes. It was found that as the severity of OSA increased, chronic systemic inflammation increased, which was determined by the ratio of neutrophils, lymphocytes, and platelets (NLR, PLR, SII).