摘要
目的 探讨阻塞性睡眠呼吸暂停低通气综合征(O SAHS)患者血白细胞计数(WBC)、纤维蛋白原(FIB)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)变化及其与病情的关系.方法 回顾性选取2022年1月至2023年12月广州中医药大学附属中山中医院耳鼻喉科收治的160例OSAHS患者作为研究组,另取同期在本院行健康体检的80名健康者作为对照组.研究组按照病情严重程度分为重度组(n=36)、中度组(n=76)及轻度组(n=48).检测并比较研究组及对照组、不同病情程度OSAHS患者血WBC、FIB、NLR、PLR水平.采用受试者操作特征(ROC)曲线分析血 WBC、FIB、NLR、PLR水平对OSAHS的诊断价值.采用Spearman相关性分析对血 WBC、FIB、NLR、PLR水平与OSAHS患者病情严重程度的关系进行分析.收集受试者的临床资料,并采用单因素分析和多因素Logistic回归分析对影响OSAHS患者病情严重程度的因素进行分析.结果 研究组血WBC、FIB、NLR、PLR水平分别为(6.87±1.39)× 109/L、(3.02±0.51)g/L、2.36±0.53、129.64±12.18,均高于对照组[(5.46±0.73)× 109/L、(2.68±0.34)g/L、1.71±0.46、115.52±7.03],差异均有统计学意义(P＜0.05).ROC曲线显示,血WBC、FIB、NLR、PLR水平联合诊断OSAHS的曲线下面积(AUC)高于4者单独诊断(P＜0.05).重度组血WBC、FIB、NLR、PLR水平均高于中度组及轻度组,而中度组血WBC、FIB、NLR、PLR水平均高于轻度组,差异均有统计学意义(P＜0.05).Spearman相关性分析显示,血WBC、FIB、NLR、PLR水平与OSAHS患者病情严重程度均呈正相关(P＜0.05).多因素Logistic回归分析显示,WBC、FIB、NLR、PLR、微觉醒指数、血氧饱和度低于90％的睡眠时间占比(T90％)、最低血氧饱和度是影响OSAHS患者病情严重程度的独立危险因素(P＜0.05).结论 OSAHS患者血WBC、FIB、NLR、PLR水平升高,4者对OSAHS具有较高的诊断效能,且与病情严重程度呈正相关.
Abstract
Objective To explore the changes of serum white blood cell count(WBC),fibrinogen(FIB),neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR),and their relationship with disease severity in patients with obstructive sleep apnea hypopnea syn-drome(OSAHS).Methods A retrospective study was conducted on 160 patients with OSAHS admitted to the Department of Otorhinolaryngology at Zhongshan Hospital of Traditional Chinese Medicine,Guangzhou University of Chinese Medicine from January 2022 to December 2023,and an additional 80 healthy individuals who underwent health check ups at our hospital during the same period were selected as the control group.Ac-cording to disease severity,patients in the study group were divided into the severe group(n=36),the moderate group(n=76)and the mild group(n=48).The levels of serum WBC,FIB,NLR and PLR were compared between the study group and the control group,and among pa-tients with different severity of OSAHS.The diagnostic value of WBC,FIB,NLR and PLR in OSAHS was analyzed by receiver operating charac-teristic(ROC)curves,and their relationship with disease severity was analyzed by Spearman correlation analysis.The clinical data of the subjects were collected,and the factors affecting the severity of OSAHS patients were analyzed by univariate analysis and multivariate logistic regression a-nalysis.Results The levels of WBC,FIB,NLR,and PLR in the study group were(6.87±1.39)× 109/L,(3.02±0.51)g/L,2.36±0.53,and 129.64±12.18,respectively,which were higher than those in the control group[(5.46±0.73)× 109/L,(2.68±0.34)g/L,1.71±0.46,115.52±7.03],and the differences were statistically significant(P＜0.05).ROC curves analysis showed that the area under the curve(AUC)of WBC combined with FIB,NLR and PLR in the diagnosis of OSAHS was greater than that of single index(P＜0.05).The levels of serum WBC,FIB,NLR and PLR were gradually decreased in the severe group,the moderate group and the mild group,and the differences were statistically significant(P＜0.05).Spearman correlation analysis showed that levels of serum WBC,FIB,NLR and PLR were positively correla-ted with disease severity in OSAHS patients(P＜0.05).Multivariate Logistic regression analysis showed that WBC,FIB,NLR,PLR,mi-croarousal index,proportion of sleep time when blood oxygen saturation＜90％(T90％)and minimum blood oxygen saturation were independent risk factors of disease severity in OSAHS patients(P＜0.05).Conclusion The levels of serum WBC,FIB,NLR and PLR are increased in pa-tients with OSAHS,which all have higher diagnostic efficiency for OSAHS and are positively correlated with disease severity.
维普
万方数据