BMI、NLR、PLR以及网织红细胞系列指标与肥胖合并OSAHS患者病情的相关性分析  

Correlation analysis of BMI,NLR,PLR and reticulocyte series indexes with the condition of obese patients with OSAHS

作　　者：张颖 刘九玉 马长秀[1] 项莹 檀竹霞 赵卉[1] ZHANG Ying;LIU Jiu-yu;MA Chang-xiu;XIANG Ying;TAN Zhu-xia;ZHAO Hui(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院呼吸与危重症医学科,安徽合肥230601

出　　处：《临床肺科杂志》2021年第1期30-35,共6页Journal of Clinical Pulmonary Medicine

基　　金：国家自然科学基金(No.81800062)。

摘　　要：目的探讨体质量指数(BMI)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、网织红细胞绝对值(RET)、未成熟网织红细胞指数(IRF)等临床资料与肥胖合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者病情严重程度的相关性,以期发现筛查肥胖患者减重代谢手术术前是否合并OSAHS的敏感指标。方法采用回顾性病例对照研究,将70名受试者根据呼吸暂停低通气指数(apnea-hypopnea index,AHI)分为四组。比较各组BMI、NLR、PLR、RET、IRF等临床资料,分析探讨上述指标与肥胖合并OSAHS患者病情严重程度的相关性。结果中重度OSAHS组患者BMI明显高于轻度及非OSAHS组,而重度组平均指脉氧饱和度(MSpO2)及最低指脉氧饱和度(LSaO2)均显著低于轻度及非OSAHS组,重度OSAHS组NLR、RET以及IRF均高于非OSAHS组,差异均具有统计学意义(P<0.05)。Logistic回归分析发现OSAHS独立预测变量为BMI、IRF,受试者工作特征曲线(ROC)分析,显示曲线下面积(AUC)分别为0.792、0.810,联合诊断AUC为0.897,敏感度为71.7%,特异度为100%。结论BMI、IRF、NLR以及RET均与肥胖合并OSAHS患者病情严重程度密切相关,而BMI和IRF两者联合诊断可用于减重代谢手术术前OSAHS的初步筛查以及患者病情严重程度的评估。Objective To discuss the correlation of body mass index(BMI),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),absolute value of reticulocyte(RET),immature reticulocyte index(IRF)and other hematological data with the severity of OSAHS in patients with obesity,in order to find out some sensitive indicators that can be used to screen OSAHS in obese patients before weight loss metabolic surgery.Methods A retrospective case-control study was conducted.70 subjects were divided into four groups according to apnea hypopnea index(AHI).The differences of clinical characteristics,such as BMI,NLR,PLR,RET,and IRF in each group were compared to analyze the correlation between the above indicators and the severity of OSAHS for obesity patients.Results The BMI of patients with moderate/severe OSAHS were significantly higher than those of the mild and non-OSAHS groups(P<0.05),while the mean oxygen saturation(MSpO2)and lowest oxygen saturation(LSaO2)of the severe group were significantly lower than the mild and non-OSAHS groups(P<0.01).The NLR,RET and IRF of patients with severe OSAHS were higher than those of the non-OSAHS group(P<0.05).Through Logistic regression analysis,it found that the independent predictive variables of OSAHS were BMI and IRF.Receiver operating characteristic curve(ROC)analysis showed that the area under the curve(AUC)was 0.792 and 0.810 respectively,and the combined diagnosis AUC was 0.897.The sensitivity was 71.7%,and the specificity was 100%.Conclusion BMI,IRF,NLR and RET are all closely related to the disease severity of obese patients with OSAHS,and the combined diagnosis of BMI and IRF can be used for the preliminary screening of OSAHS before weight loss metabolism surgery and the assessment of the severity of OSAHS.

关 键 词：肥胖 阻塞性睡眠呼吸暂停低通气综合征 体质量指数 中性粒细胞与淋巴细胞比值 网织红细胞绝对值 未成熟网织红细胞指数 

分 类 号：R766[医药卫生—耳鼻咽喉科] R589.2[医药卫生—临床医学]