Correlation analysis of fractional exhaled nitric oxide and serum phospholipase A2 level with obstructive sleep apnea hypopnea syndrome in COPD patients
Objective:To analyze the correlation between fractional exhaled nitric oxide(FeNO)and serum phospholipase A2(PLA2)level with obstructive sleep apnea hypopnea syndrome(OSAHS)in chronic obstructive pulmonary disease(COPD)patients.Methods:A total of 164 COPD patients admitted to Pulmonary Hospital of Lanzhou from June 2021 to June 2024 were selected as the research subjects,and the data were retrospectively analyzed.Among them,stable COPD patients were included in the stable group(n=95),and COPD patients with OSAHS were included in the sleep disorder group(n=69).FeNO,eosinophil(EOS)percentage,serum C-reactive protein(CRP),procalcitonin(PCT),and PLA2 levels were compared between the two groups.Logistic regression model was used to analyze the correlation between FeNO,EOS percentage,serum CRP,PCT,PLA2 levels and COPD complicated with OSAHS.Receiver operating characteristic(ROC)curve was used to evaluate FeNO,EOS percentage.The value of serum CRP,PCT and PLA2 levels alone and FeNO and serum PLA2 levels combined in predicting OSAHS in COPD patients.Results:FeNO,EOS percentage and serum CRP,PCT and PLA2 levels in sleep disorder group were significantly higher than those in stable period group(P＜0.05).Logistic regression model analysis showed that FeNO,EOS percentage and serum CRP,PCT and PLA2 levels were risk factors affecting OSAHS in COPD patients(P＜0.05).In ROC curve,the AUC of FeNO,EOS percentage and serum CRP,PCT and PLA2 levels independently predicting OSAHS in COPD patients were 0.767,0.631,0.645,0.647 and 0.707,respectively.The sensitivity was 81.16%,76.81%,82.61%,47.83%,60.87%,and the specificity was 66.32%,48.42%,42.11%,81.05%,75.79%,respectively.The cut-off values were 24.37%,5.31%,8.51 mg/L,0.80 ng/mL and 174.25 ng/mL,respectively.The AUC of FeNO and serum PLA2 in predicting OSAHS in COPD patients was significantly higher than that of serum CRP,PCT and PLA2 levels(P＜0.05).The AUC of FeNO and serum PLA2 combined predicted OSAHS in COPD patients was 0.816,the sensitivity was 81.16%,and the specificity was 70.53%.Conclusions:FeNO and serum PLA2 levels are closely related to OSAHS complications in COPD patients,and are more valuable in diagnosis and prediction than conventional inflammatory indicators.
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