男性阻塞性睡眠呼吸暂停低通气综合征患者血液学指标与睡眠呼吸暂停低通气指数的关系

Relationship between hematologic index and sleep apnea hypopnea index in male patients with obstructive sleep apnea hypopnea syndrome

摘要:

目的 了解男性阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的血液常规及生化指标和睡眠呼吸暂停低通气指数（AHI）的关系。方法 对2011年1月—2019年12月住院手术治疗且入院前整夜睡眠监测数据完整的474例成年男性患者进行回顾性研究。根据AHI将患者分为4组：A组（AHI<30次/h，56例）、B组（30次/h≤AHI<60次/h，162例）、C组（60次/h≤AHI<90次/h，217例）和D组（AHI≥90次/h，39例）。收集的数据包括睡眠参数、Epworth嗜睡量表评分（ESS）、血液常规及生化指标和人口统计学特征。结果 4组患者的红细胞计数、血小板计数、白细胞计数、中性粒细胞、谷丙转氨酶（ALT）、谷草转氨酶（AST）、AST/ALT、葡萄糖、尿酸、甘油三酯、高密度脂蛋白差异均具有统计学意义（P<0.05）；高密度脂蛋白和甘油三酯与AHI的线性相关性较好，且前者呈负相关，后者呈正相关（r=-0.252，r=0.192）；多元线性回归分析表明红细胞计数（β=0.140，P=0.004）和甘油三酯（β=0.122，P=0.017）与AHI独立相关，多个相关系数R²=0.332。结论 高密度脂蛋白、甘油三酯与AHI的线性相关性较好，且前者呈负相关（r=-0.252），后者呈正相关（r=0.192），红细胞计数、甘油三酯与AHI独立相关，有潜力成为判断经多导睡眠监测（PSG）检查后诊断为OSAHS患者综合严重程度的辅助指标。

关键词:睡眠呼吸暂停;阻塞性;血液学检查;多导睡眠图

Abstract:

Objective To investigate the relationship between blood routine and biochemical indexes and sleep apnea hypopnea index (AHI) in male patients with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods A retrospective study was performed on 474 adult male patients who underwent surgery in our department from Jan 2011 to Dec 2019 and had complete sleep monitoring data prior to admission. According to AHI, patients were divided into four groups:Group A (AHI<30 times/h, n=56), group B (30 times/h ≤ AHI<60 times/h, n=162), group C (60 times/h ≤ AHI<90 times/h, n=217), and group D (AHI ≥ 90 times/h, n=39). Data collected included sleep parameters, the Epworth Sleeping Scale, blood routine and biochemical indexes and demographic characteristics.Results There were statistically significant differences in red blood cell count, platelet count, white blood cell count, neutrophils, alanine aminotransferase (AST), aspartate aminotransferase (ALT), AST/ALT, glucose, uric acid, triglyceride and high-density lipoprotein among the four groups (P<0.05). With good linear correlations between high-density lipoprotein and triglycerides and AHI, the former showed negative correlation while the latter showed positive correlation (r=-0.252, r=0.192). Multiple linear regression analysis showed that erythrocyte count (β=0.140, P=0.004) and triglyceride (β=0.122, P=0.017) were independently correlated with AHI, with multiple correlation coefficients R²=0.332.Conclusion With good linear correlations, high-density lipoprotein is negatively and triglyceride is positively correlated with AHI(r=-0.252,r=0.192), and the red blood cell count and triglyceride are independently correlated with AHI, which have the potential to be auxiliary indicators to judge the comprehensive severity of OSAHS patients diagnosed with polysomnography.

Key words:Sleep apnea;Obstructive;Hematological index;Polysomnogram