摘要
目的探讨血清瘦素(LEP)、抵抗素(RES)、脂联素(ADP)联合血尿酸(BUA)对阻塞性睡眠呼吸暂停低通气综合症(OSAHS)患者并发冠心病(CHD)的预测价值。方法选取2021年6月~2024年12月我科收治的315例单纯OSAHS患者作为OSAHS组、315例OSAHS并发CHD患者作为CHD组,另选取同期于本院体检的健康人群315例作为对照组。根据OSAHS病情程度将OSAHS组和CHD组共630例患者分为轻度组(138例)、中度组(202例)及重度组(290例)。收集所有受试者临床资料、实验室检查结果及血清LEP、RES、ADP、BUA水平并分组进行比较。采用受试者工作特征(ROC)曲线分析血清LEP、RES、ADP联合BUA对OSAHS患者并发CHD的预测价值。结果CHD组、OSAHS组、对照组受试者血清LEP、RES和BUA水平依次降低,ADP水平依次升高(P<0.05)。CHD组患者睡眠呼吸暂停低通气指数(AHI)、氧减指数(ODI)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均高于OSAHS组,夜间最低脉搏血氧饱和度(LSpO_(2))低于OSAHS组(P<0.05)。轻度、中度、重度组OSAHS血清LEP、RES、BUA水平及CHD发生率依次升,ADP水平依次降低(P<0.05)。ROC曲线分析结果显示,血清LEP、RES、ADP联合BUA预测OSAHS患者及轻度、中度、重度OSAHS患者并发CHD的敏感度均高于各指标单独预测,曲线下面积(AUC)均高于各指标单独预测(P<0.05)。结论OSAHS及并发CHD患者血清LEP、RES、BUA水平均升高,ADP水平降低,且均对OSAHS患者并发CHD均具有一定的预测价值,且四者联合预测价值更高。
Objective To explore the predictive value of serum leptin(LEP),resistin(RES),adiponectin(ADP)combined with blood uric acid(BUA)on coronary heart disease(CHD)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 315 patients with simple OSAHS admitted to our hospital from June 2021 to December 2024 were selected as OSAHS group,315 OSAHS patients with CHD were selected as CHD group,315 healthy individuals who underwent physical examination at our hospital during the same period were selected as control group.According to the severity of OSAHS,630 patients in OSAHS group and CHD group were divided into mild group(138 cases),moderate group(202 cases)and severe group(290 cases).The clinical data,laboratory test results and serum levels of LEP,RES,ADP and BUA of all subjects were collected and grouped for comparison.The predictive value of serum LEP,RES,ADP combined with BUA for CHD in OSAHS patients was analyzed by the receiver operating characteristic(ROC)curve.Results The serum levels of LEP,RES and BUA in CHD group,OSAHS group and control group decreased sequentially,while the level of ADP increased sequentially(P<0.05).The sleep apnea hypopnea index(AHI),oxygen depletion index(ODI),triglycerides(TG)and lowdensity lipoprotein cholesterol(LDLC)levels in CHD group were higher than those in OSAHS group,and the nighttime lowest pulse oxygen saturation(LSpO_(2))was lower than that in OSAHS group(P<0.05).The serum LEP,RES and BUA levels in moderate and severe OSAHS groups were higher than those in mild group,while the ADP level was lower than that in mild group(P<0.05).The serum lovels of LEP,RES,BUA and incidence of CHD in mild group,moderate group and severe group increased sequentially,while the level of ADP decreased sequentially(P<0.05).ROC curve analysis results showed that the sensitivity of serum LEP,RES,ADP combined with BUA in predicting CHD in patients with OSAHS and those with mild,moderate and severe OSAHS was higher than that predicted by each index alone,and the area under the curve(AUC)was also higher than that predicted by each index alone(P<0.05).Conclusion The levels of serum LEP,RES and BUA in OSAHS patients and patients with CHD all increase,while the level of ADP decrease,all of which have certain predictive value for OSAHS patients with coronary heart disease,and the combined predictive value of the four is higher.
作者
陈杰
刘涛
Chen Jie;Liu Tao(Department ofRespiratory,the Second Hospital ofShanxi Medical University,Taiyuan 030001,China)
出处
《临床内科杂志》
2025年第10期828-832,共5页
Journal of Clinical Internal Medicine
关键词
阻塞性睡眠呼吸暂停低通气综合症
瘦素
抵抗素
脂联素
血尿酸
冠心病
Obstructive sleep apnea hypopnea syndrome
Leptin
Resistin
Adiponectin
Blood uric acid
coronary heart disease
