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[1]陈晓毅,尹雪霞,刘 静,等.阻塞性睡眠呼吸暂停低通气综合征并发肺动脉高压的危险因素及预测分析[J].中华肺部疾病杂志,2024,(01):41-45.[doi:10.3877/cma.j.issn.1674-6902.2024.01.008]
　Chen Xiaoyi,Yin Xuexia,Liu Jing,et al.Risk factors and predictive analysis of obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension[J].,2024,(01):41-45.[doi:10.3877/cma.j.issn.1674-6902.2024.01.008]
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阻塞性睡眠呼吸暂停低通气综合征并发肺动脉高压的危险因素及预测分析(PDF)

《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2024年01期
页码:
41-45
栏目:
论著
出版日期:
2024-02-20

文章信息/Info

Title:
Risk factors and predictive analysis of obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension
作者:
陈晓毅1; 尹雪霞2; 刘 静1; 邬国松3
510000 广州,南方医科大学南方医院白云分院呼吸与危重症医学科1、内分泌科2、药学部3
Author(s):
Chen Xiaoyi1;  Yin Xuexia2;  Liu Jing1;  Wu Guosong3.
1Department of Respiratory and Critical Care Medicine; 2Department of Endocrinology; 3Department of Pharmacy, Nanfang Hospital of Southern Medical University, Guangzhou 510000, China
关键词:
低通气综合征; 呼吸暂停; 睡眠; 阻塞性;  肺动脉高压;  列线图预测模型
Keywords:
Obstructive sleep apnea-hypopnea syndrome;  Pulmonary hypertension;  Line graph prediction model
分类号:
R563.9
DOI:
10.3877/cma.j.issn.1674-6902.2024.01.008
摘要:
目的 构建阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)并发肺动脉高压的列线图预测模型,分析预测价值。方法 选取2021年7月到2023年2月我院收治的127例OSAHS患者为对象,单纯OSAHS 92例为对照组,OSAHS并发肺动脉高压35例为观察组。分析OSAHS并发肺动脉高压的危险因素,构建OSAHS并发肺动脉高压的列线预测模型。结果 OSAHS并发肺动脉高压有基础疾病史、近期急性细菌感染史、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio, NLR)、血小板/淋巴细胞比值(platelet-lymphocyte ratio, PLR)、C反应蛋白(C-reactive protein, CRP)、红细胞分布宽度(red blood cell distribution width, RDW)、内皮素-1(endothelin-1, ET-1)较高,亚硝酸盐、脉搏血氧饱和度(SpO2)、心输出量、一氧化氮(nitric oxide, NO)较低(P<0.05)。多因素Logistics回归分析显示:近期急性细菌感染史[OR(95%CI):4.815(3.580～6.052)]、NLR[OR(95%CI):3.284(2.362～4.206)]、PLR[OR(95%CI):5.124(23.942～6.306)]、CRP[OR(95%CI):3.688(2.754～4.622)]、RDW[OR(95%CI):4.129(3.377～4.881)]、亚硝酸盐[OR(95%CI):4.958(3.766～6.150)]、SpO2[OR(95%CI):5.607(4.471～6.743)]、心输出量[OR(95%CI):4.116(3.390～4.842)]、NO[OR(95%CI):4.968(3.832～6.104)]、ET-1[OR(95%CI):5.228(4.108～6.348)]为OSAHS并发肺动脉高压的危险因素(P<0.05)。绘制OSAHS并发肺动脉高压的列线预测模型,敏感度、特异度、准确性、曲线下面积及95%CI分别为91.47%、92.68%、91.81%、0.921(0.882～0.960)。结论 近期急性细菌感染史、NLR、PLR、CRP、RDW、亚硝酸盐、SpO2、心输出量、NO、ET-1是OSAHS并发肺动脉高压危险因素,列线图预测模型可有效预测OSAHS并发肺动脉高压。
Abstract:
Objective To construct a column chart prediction model for obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension and analyze its predictive value. Methods A total of 127 patients with obstructive sleep apnea-hypopnea syndrome admitted to our hospital from July 2021 to February 2023 were selected as the study objects, 92 patients with simple obstructive sleep apnea-hypopnea syndrome were selected as the control group, and 35 patients with obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension were selected as the observers. The risk factors of obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension were analyzed, and the linear prediction model of obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension was constructed. Results Patients with obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension have a history of underlying diseases, a proportion of recent history of acute bacterial infection, NLR, PLR, CRP, RDW, ET-1 levels, and higher levels of nitrite, SpO2, cardiac output and NO level were relatively low(P<0.05). Multivariate logistic regression analysis showed that recent acute bacterial infection history [OR(95%CI): 4.815(3.580-6.052)], NLR [OR(95%CI): 3.284(2.362-4.206)], PLR[OR(95%CI): 5.124(23.942-6.306)], CRP[OR(95%CI): 3.688(2.754-4.622)], RDW[OR(95%CI): 4.129(3.377-4.881)], nitrite [OR(95%CI): 4.958(3.766-6.150)], SpO2[OR(95%CI): 5.607(4.471-6.743)], cardiac output [OR(95%CI): 4.116(3.390-4.842)]〗, NO[OR(95%CI): 4.968(3.832-6.104)] and ET-1[OR(95%CI): 5.228(4.108-6.348)] were the main factors affecting obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension(P<0.05). Based on recent history of acute bacterial infection, NLR, PLR, CRP, RDW, nitrite, SpO2, cardiac output, NO, and ET 110 independent risk factors, a column-line prediction model for obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension was drawn using a column-line online website. The sensitivity, specificity, accuracy, area under the curve and 95%CI of the prediction model for obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension were 91.47%, 92.68%, 91.81% and 0.921(0.882-0.960), respectively. Conclusion Recent history of acute bacterial infection, NLR, PLR, CRP, RDW, nitrite, SpO2, cardiac output, NO and ET-1 are all associated with obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension. The prediction model based on the above indexes can effectively predict obstructive sleep apnea-hypopnea syndrome complicated with pulmonary hypertension.

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备注/Memo

备注/Memo:
基金项目: 广东省医学科学技术研究基金项目(A2021136)
通信作者:陈晓毅, Email: cxylcly@163.com
更新日期/Last Update: 2024-02-20