甘肃地区OSA继发红细胞增多症的相关因素分析  

Analysis of related factors in secondary erythrocytosis of obstructive sleep apnea hypopnea syndrome in Gansu province

作　　者：王金凤[1] 方金瑞[2] 谢宇平[1] 马薇[1] 惠培林[1] 苏晓燕 郭斌[1] 陈雪萍 王旭斌 范杰 赵媛 WANG Jinfeng;FANG Jinrui;XIE Yuping;MA Wei;HUI Peilin;SU Xiaoyan;GUO Bin;CHEN Xueping;WANG Xubin;FAN Jie;ZHAO Yuan(Department of Sleep Medicine Center,Gansu Provincial Hospital,Lanzhou,730000,China;Department of Day Care Center,Gansu Provincial Hospital)

机构地区：[1]甘肃省人民医院睡眠医学中心,兰州730000 [2]甘肃省人民医院日间诊疗中心

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第5期338-342,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：国家自然科学基金(No:81560228,61962034);2019年甘肃省卫生行业科研计划项目(No:GSWSKY-2019-88);甘肃省科技计划项目(No:20JR10RA437);甘肃省人民医院院内基金项目(No:18GSSY4-19,21GSSYC-25)。

摘　　要：目的:分析甘肃地区阻塞性睡眠呼吸暂停(OSA)继发红细胞增多症的相关因素。方法:收集2013年1月—2021年1月长居甘肃的汉族OSA患者448例,按照血红蛋白(Hb)值分为A、B、C、D、E组,分别为正常(Hb 120~160 g/L)41例、轻度增高(Hb 161~179 g/L)142例、中度增高(Hb 180~199 g/L)156例、重度增高(Hb 200~219 g/L)79例、极重度增高(Hb≥220 g/L)30例。对所有患者进行PSG监测,比较三组的一般临床资料、居住地海拔高度、病程、呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSpO_(2))、平均血氧饱和度(MSpO_(2)),并用多因素回归及ROC曲线分析OSA继发红细胞增多症的影响因素。结果:A、B、C、D、E组间年龄、性别及病程的差异无统计学意义(P>0.05)。E组海拔高度高于A、B、C、D组(P<0.05),A、B、C、D组之间海拔高度的差异无统计学意义(P>0.05);各组间的AHI差异有统计学意义(P<0.05),其中C、D、E组显著高于A组,D组显著高于B、C组;各组间的LSpO_(2)差异有统计学意义(P<0.05),其中B、C、D、E组显著低于A组,D、E组显著低于B、C组;各组间的MSpO_(2)差异有统计学意义(P<0.05),其中B、C、D、E组显著低于A组,D、E组显著低于B、C组。多因素回归显示:海拔越高、MSpO_(2)越低,引起继发高血红蛋白血症的程度越严重;年龄、病程、AHI及LSpO_(2)均不是OSA继发血红蛋白增多的影响因素。MSpO_(2)、海拔高度预测Hb≥180 g/L的ROC曲线下面积分别为0.694(P<0.001)、0.570(P=0.009),差异有统计学意义(Z=3.205,P=0.001)。结论:海拔高度、MSpO_(2)是引起OSA继发红细胞增多症的独立危险因素;MSpO_(2)预测OSA患者Hb≥180 g/L优于海拔高度。Objective:To analyze the related factors of secondary erythrocytosis of obstructive sleep apnea(OSA)in Gansu province.Methods:Polysomnography recording and analysis from January 2013 to January 2021,A total of 448 OSA patients of long-resident Han nationality in Gansu province.Hemoglobin(Hb)values were divided into group A(Hb 120-160 g/L)41 cases,B(Hb 161-179 g/L)142 cases,C(Hb 180-199 g/L)152 cases,D(Hb 200-219 g/L)79 cases,and E(Hb≥220 g/L)30 cases.General clinical data,altitude of residence,disease course,apnea hypopnea index(AHI),and Lowest oxyhemoglobin(LSpO_(2))were compared among these groups.Multivariate regression and ROC curves were used to analyze the influencing factors of OSA secondary erythrocytosis.Results:There were no significant differences in age,sex,and course of disease among groups A,B,C,D,and E(P>0.05).The altitude of group E was higher than that of groups A,B,C,and D(P<0.05),but there was no significant difference between groups A,B,C and D(P>0.05).AHI was significantly different among groups A,B,C,D,and E(P<0.05),groups C,D,and E were significantly higher than A;group D was significantly higher than B,C.LSpO_(2)was significantly different among groups A,B,C,D,and E(P<0.05),groups B,C,D,and E was significantly lower than A;group D,E was significantly lower than B,C.MSpO_(2)was significantly different among groups A,B,C,D,and E(P<0.05),groups B,C,D,and E was significantly lower A;groups D,E was significantly lower than B,C.Multivariate regression showed that the higher the altitude,the lower the MSpO_(2),the more serious the secondary hyperhemoglobinemia.Age,course of the disease,AHI,and LSpO_(2)were not the influencing factors of OSA secondary hemoglobin increase.The areas under the ROC curve for MSpO_(2)and altitude to predict Hb≥180 g/L were 0.694(P<0.001)and 0.570(P=0.009),with statistically significant differences(Z=3.205,P=0.001).Conclusion:Altitude and MSpO_(2)were independent risk factors for OSA secondary erythrocytosis;MSpO_(2)predicted that Hb≥180 g/L in OSA patients was be

关 键 词：睡眠呼吸暂停 阻塞性 继发红细胞增多症 平均血氧饱和度 海拔高度 

分 类 号：R766[医药卫生—耳鼻咽喉科]