摘要
目的采用ROC曲线评价心电图推导呼吸曲线(EDR)联合血清载脂蛋白B(apoB)/载脂蛋白A(apoA-I)对冠心病睡眠呼吸暂停综合征(SAS)的初筛价值。方法选取2015年9月-2017年9月青海省人民医院80例SAS冠心病患者为SAS组,80例无SAS冠心病患者为冠心病组,80名健康体检人群为对照组。采用EDR监测记录夜间睡眠指标,采用便携式血氧饱和度检测仪检测血氧饱和度(SaO2);检测血清apoB、apoA-I并计算两者的比值;采用ROC曲线判定EDR、血清apoB/apoA-I单项筛查和联合检测的筛查价值。结果SAS组7 h内低通气次数、低通气指数(AHI)、SIT90(SaO2≤90%的时间占总监测时间的百分比)显著高于冠心病组和对照组(P<0.05),夜间最低SaO2、平均SaO2显著低于冠心病组和对照组(P<0.05);冠心病组和对照组上述指标差异无统计学意义(P>0.05)。EDR筛查的敏感度为68.75%,特异度为81.25%,ROC曲线下面积为0.701。SAS组apoB、apoB/apoA-I显著高于冠心病组和对照组(P<0.05),冠心病组apoB、apoB/apoA-I显著高于对照组(P<0.05);三组血清apoA-I差异无统计学意义(P>0.05)。apoB/apoA-I的截断值为0.716,敏感度为51.25%,特异度为78.13%,ROC曲线下面积为0.686。联合检测的ROC曲线下面积为0.895,敏感度为87.50%,均显著高于单项筛查(P<0.05),联合检测的特异度为70.61%,与单项筛查差异无统计学意义(P>0.05)。结论EDR联合血清apoB/apoA-I对SAS冠心病具有较高的筛查价值。
Objective To study the use of ROC curve to evaluate the value of electrocardiogram derived respiration(EDR)combined with serum apoB/apoA-I in screening of sleep apnea syndrome(SAS)patients with coronary heart disease.Methods 80 patients with coronary heart disease(CHD)and SAS from September 2015 to September 2017 were selected as the SAS group,and 80 CHD patients without SAS were selected as CHD group,and 80 health volunteers were set as control group.EDR monitoring was used to record nighttime sleep indicators and blood oxygen saturation(SaO2);serum apoB and apoA-I were measured and the ratio of the two was calculated.ROC curve was used to determine EDR and serum apoB/apoA-I single screening and combined screening value.Results The frequency of hypoventilation,AHI and SIT90(SaO2<90%of the total monitoring time)in SAS group were significantly higher than those of the other two groups(P<0.05),and the L(SaO2)were significantly lower than those of the other two groups(P<0.05).There was no significant difference in the above indexes between CHD group and control group(P>0.05).The sensitivity and specificity of EDR screening were 68.75%and 81.25%,respectively;the area under ROC curve was 0.701.ApoB and apoB/apoA-I in SAS group were significantly higher than those of the other two groups(P<0.05).ApoB and apoB/apoA-I in CHD group were significantly higher than those of control group(P<0.05).There was no significant difference in serum apoA-I among the three groups(P>0.05).The cut-off value of apoB/apoA-I was 0.716,and sensitivities were 51.25%and 78.13%,respectively;the area under ROC curve was 0.686.The area under ROC curve was 0.895 and the sensitivity was 87.50%,which was significantly higher than those of single detection(P<0.05).The specificity of combined detection was 70.61%,which showed no significant difference with single detection(P>0.05).Conclusion EDR combined with serum apoB/apoAI had high screening value for SAS coronary heart disease.
作者
薛小琴
常荣
XUE Xiao qin;CHANG Rong(Cardiac Function Room of Cardiology Division I(Cardiac Intervention Department)of Qinghai People′s Hospital,Xining,Qinghai 810001,China)
出处
《热带医学杂志》
CAS
2019年第12期1550-1553,1563,共5页
Journal of Tropical Medicine
作者简介
薛小琴(1984-),女,硕士,主治医师,研究方向:心电图诊断及分析;通讯作者:常荣,E mail:qhschangrong@126.com
