血小板与阻塞性睡眠呼吸暂停低通气综合征合并高血压病的相关性研究  

The Relationship of Platelet-Related Parameters with Obstructive Sleep Apnea Hypopnea Syndrome and Hypertension in Patients

作　　者：林婷[1] 陈公平[1] 黄杰凤 王碧瑛[1] 赵建铭[1] 林其昌[1] LIN Ting;CHEN Gongping;HUANG Jiefeng;WANG Biying;ZHAO Jianming;LIN Qichang(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Fujian Medical University,Fujian Provincial Sleep-Disordered Breathing Clinic Center,Institute of Respiratory Disease of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院呼吸与危重症医学科,福建省睡眠呼吸疾病诊治中心,福建医科大学呼吸系病研究所,福州350005

出　　处：《福建医科大学学报》2020年第6期406-410,共5页Journal of Fujian Medical University

基　　金：福建省卫计委医学创新课题(2017-CX-24)。

摘　　要：目的探讨血小板相关参数如平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板/淋巴细胞比值(PLR)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压病的相关性。方法收集2016年1月-2019年8月因日间嗜睡或夜间睡眠时打鼾就诊的患者215例,男性185例,女性30例,年龄(51.27±10.67)岁(24~75岁),根据是否合并高血压病分为OSAHS合并高血压病组(n=117)和单纯OSAHS组(n=98)。比较两组间一般资料、血小板相关参数等指标是否存在差异。采用Spearman相关分析探讨MPV及PLR与指标的相关性;采用Logistic回归分析进一步评估影响OSAHS合并高血压病的因素。结果两组的MPV及PLR差别均有统计学意义(P<0.05)。经相关分析发现,MPV与体质量指数(BMI)、睡眠呼吸暂停低通气指数(AHI)、呼吸暂停低通气时间指数(AHTI)、氧饱和度低于90%的时间占监测时间的百分比(TS90%)、氧减指数(ODI)及腰围呈正相关(均P<0.05),与夜间最低血氧饱和度(LaSO2)及夜间平均血氧饱和度(MSaO2)呈负相关(均P<0.05)。PLR与TS90%呈正相关(P<0.05),与LaSO2呈负相关(P<0.05)。进一步行Logistic回归分析显示,MPV(OR=2.042,P<0.001)及PLR(OR=1.021,P=0.003)是OSAHS合并高血压病的独立危险因素。结论MPV和PLR可能是OSAHS合并高血压病的重要因素,与OSAHS严重程度相关。Objective To evaluate the relationship of platelet-related parameters,such as mean platelet volume(MPV),platelet distribution width(PDW),and platelet-to-lymphocyte ratio(PLR)with Obstructive sleep apnea hypopnea syndrome(OSAHS)and hypertension in patients.Methods Patients with excessive daytime sleepiness or nocturnal snoring from January 2016 to August 2019 were recruited.A total of 215 participants including 185 males and 30 females were analyzed,with mean age(51.27±10.67)years(range:24-75 years).According to the hypertension,they were classified into two groups,including OSAHS group and OSAHS with hypertension.There were 117 subjects in OSAHS with hypertension group and 98 subjects in OSAHS group.The differences in clinical characteristic,platelet-related parameters,PSG-related parameters total cholesterol and triglyceride were tested.Spearman correlation was used to analyze the factors associated with MPV and PLR,and Logistic regression analysis was conducted to obtain the independent risk factors for OSAHS complicated with hypertension.Results Compared with the OSAHS group,MVP and PLR in OSAHS with hypertension group showed significant difference(P<0.05).MVP was positively correlated with body mass index(BMI),apnea hypopnea index(AHI),apnea hypopnea time index(AHTI),percentage of total sleep time spent with SaO2<90%(TS90%),oxygen desaturation index(ODI),and waist circumference were negatively correlated with lowest O2 saturation(LaSpO2)and mean O2 saturation(MaSaO2)(P<0.05).PLR was positively correlated with TS90%and negatively correlated with LaSpO2(P<0.05).Logistic regression analysis showed that MPV(OR=2.042,P<0.001)and PLR(OR=1.021,P=0.003)were the independent risk factors of OSAHS complicated with hypertension.Conclusions MPV and PLR may be the important factors for incidence of hypertension in OSAHS patients,and closely associated with the severity of OSAHS.

关 键 词：血小板 淋巴细胞 睡眠呼吸暂停 阻塞性 睡眠呼吸暂停综合征 高血压 

分 类 号：R329.24[医药卫生—人体解剖和组织胚胎学] R392.11[医药卫生—基础医学]