摘要
目的探讨外周血炎症指标对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生脑卒中的预测价值。方法回顾性选取2022年1月—2023年6月苏州市中医医院收治的OSAHS患者142例为研究对象。收集患者的一般资料、OSAHS病情特征、外周血炎症指标[中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)、全身免疫炎症指数(SII)],根据是否发生脑卒中将患者分为脑卒中组(n=31)和无脑卒中组(n=111)。采用单因素及多因素Logistic回归分析探讨OSAHS患者发生脑卒中的影响因素;采用ROC曲线分析NLR、SII及二者联合对OSAHS患者发生脑卒中的预测价值。结果脑卒中组体质指数、有糖尿病者占比、有高脂血症者占比、有吸烟史者占比、有冠心病家族史者占比、呼吸暂停低通气指数(AHI)、OSAHS严重程度为重度者占比、NLR、SII高于无脑卒中组,最低动脉血氧饱和度低于无脑卒中组,OSAHS病程长于无脑卒中组(P<0.05)。单因素Logistic回归分析结果显示,体质指数、糖尿病、高脂血症、吸烟史、冠心病家族史、AHI、最低动脉血氧饱和度、OSAHS严重程度、OSAHS病程、NLR、SII可能是OSAHS患者发生脑卒中的影响因素(P<0.05)。多因素Logistic回归分析结果显示,最低动脉血氧饱和度[OR=0.859,95%CI(0.747~0.988)]、NLR[OR=66.480,95%CI(6.810~648.947)]、SII[OR=1.029,95%CI(1.012~1.047)]是OSAHS患者发生脑卒中的独立影响因素(P<0.05)。ROC曲线分析结果显示,NLR、SII预测OSAHS患者发生脑卒中的AUC分别为0.719[95%CI(0.593~0.844)]、0.761[95%CI(0.657~0.866)],二者联合预测OSAHS患者发生脑卒中的AUC为0.869[95%CI(0.783~0.955)]。二者联合预测OSAHS患者发生脑卒中的AUC大于NLR、SII单独预测OSAHS患者发生脑卒中的AUC(P<0.05)。结论NLR、SII是OSAHS患者发生脑卒中的独立影响因素,二者联合对OSAHS患者发生脑卒中有一定预测价值。
Objective To explore the predictive value of peripheral blood inflammatory indexes for stroke in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 142 OSAHS patients admitted to Suzhou Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were retrospectively selected as the research subjects.General information,characteristics of OSAHS,and peripheral blood inflammatory indexes[neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte ratio(MLR)and systemic immune inflammation index(SII)]of the patients were collected.The patients were divided into the stroke group(n=31)and the non-stroke group(n=111)according to whether stroke occurred.Univariate and multivariate Logistic regression analysis were used to explore the influencing factors of stroke in patients with OSAHS.The ROC curve was used to explore the predictive value of the NLR,SII and their combination for stroke in patients with OSAHS.Results The body mass index,proportion of patients with diabetes,proportion of patients with hyperlipidemia,proportion of patients with smoking history,proportion of patients with family history of coronary heart disease,apnea-hypopnea index(AHI),proportion of patients with severe OSAHS,NLR,and SII in stroke group were higher than those in non-stroke group,the lowest arterial oxygen saturation was lower than that in non-stroke group,and the course of OSAHS was longer than that in non-stroke group(P<0.05).Univariate Logistic regression analysis showed that body mass index,diabetes,hyperlipidemia,smoking history,family history of coronary heart disease,AHI,lowest arterial oxygen saturation,severity of OSAHS,course of OSAHS,NLR,and SII might be the influencing factors of stroke in patients with OSAHS(P<0.05).Multivariate Logistic regression analysis showed that the lowest arterial oxygen saturation[OR=0.859,95%CI(0.747-0.988)],NLR[OR=66.480,95%CI(6.810-648.947)],and SII[OR=1.029,95%CI(1.012-1.047)]were the independent influencing factors of stroke in patients with OSAHS(P<0.05).ROC curve analysis showed that the AUC of the NLR,and SII in predicting stroke in patients with OSAHS was 0.719[95%CI(0.593-0.844)],0.761[95%CI(0.657-0.866)],respectively,the AUC of their combination in predicting stroke in patients with OSAHS was 0.869[95%CI(0.783-0.955)].The AUC of their combination in predicting stroke in patients with OSAHS was larger than the AUC of the NLR,and SII in predicting stroke in patients with OSAHS alone(P<0.05).Conclusion The NLR,and SII are the independent influencing factors of stroke in patients with OSAHS,and their combination has certain predictive value for stroke in patients with OSAHS.
作者
顾燕兰
浦明之
周运海
GU Yanlan;PU Mingzhi;ZHOU Yunhai(Department of Respiratory and Critical Care,Suzhou Hospital of Traditional Chinese Medicine,Suzhou 215007,China)
出处
《实用心脑肺血管病杂志》
2025年第3期63-67,79,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
苏州市医学重点学科建设项目(SZXK202112)。
作者简介
通信作者:浦明之,E-mail:2509049360@qq.com。
