Hs-CRP、FAR、NLR水平对合并阻塞性睡眠呼吸暂停低通气综合征的无症状脑梗死患者预后的预测价值  

The predictive value of hs-CRP、FAR、NLR levels for asymptomatic cerebral infarction combined with obstructive sleep apnea hypopnea syndrome patients

作　　者：高冕 杨雄杰 周守贵 GAO Mian(Department of Neurology,Wuhu Traditional Chinese Medicine Hospital,Wuhu 241000,China)

机构地区：[1]芜湖市中医医院神经内科,安徽芜湖241000

出　　处：《牡丹江医学院学报》2023年第5期35-39,共5页Journal of Mudanjiang Medical University

基　　金：安徽省中医发展专项基金项目[皖中医药发展秘(2021)18号];芜湖市科学技术计划基金项目(2021cg33)。

摘　　要：目的探讨血清超敏C反应蛋白(hs-CRP)、纤维蛋白原/白蛋白比值(FAR)、中性粒细胞/淋巴细胞比值(NLR)水平对合并阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的无症状脑梗死(asymptomatic cerebral infarction,ACI)患者预后的预测价值。方法选取117名符合ACI诊断标准的住院及门诊患者,通过多导睡眠监测将其分为单纯ACI组(n=70)、ACI合并OSAHS组(ACI+OSAHS组,n=47),再选取健康体检者作为对照组(n=50),ACI+OSAHS组通过12个月随访过程中有无不良事件发生分为不良事件组和无不良事件组。比较各组血清中hs-CRP、FAR、NLR的水平,建立Logistic回归模型和绘制ROC曲线分析hs-CRP、FAR、NLR与ACI+OSAHS组不同预后的关系及对发生不良事件的预测价值。结果与单纯ACI组及对照组相比,ACI+OSAHS组的hs-CRP、FAR、NLR水平升高(P<0.01),不良事件组hs-CRP、FAR、NLR水平较无不良事件组升高(P<0.05),hs-CRP、FAR、NLR是ACI+OSAHS患者发生不良预后的独立危险因素,ROC曲线得出hs-CRP、FAR联合NLR预测ACI+OSAHS患者发生不良事件的曲线下面积(AUC)值为0.898(95%CI:0.774~0.973),AUC值高于单独指标预测及两两指标联合预测。结论炎症因子hs-CRP、FAR、NLR在ACI+OSAHS患者中高表达并对疾病预后有预测作用,且三者联合预测价值更高。Objective To analyze the predictive value of serum hypersensitivity C-reactive protein(hs-CRP),Fibrinogen to albumin ratio(FAR),Neutrophil to lymphocyte ratio(NLR)levels for asymptomatic cerebral infarction(ACI)combined with obstructive sleep apnea hypopnea syndrome(OSAHS)patients.Methods 117 inpatients and outpatients who met the diagnostic criteria of asymptomatic cerebral infarction were selected.By polysomnography,the patients were divided into simple ACI group(n=70),ACI combined with OSAHS group(ACI+OSAHS group,n=47).Healthy subjects were selected as control group(n=50).The patients of ACI+OSAHS group were divided into adverse event group and without adverse event group according to whether adverse events occurred during the follow-up visit within 12 months.After comparing the difference of hs-CRP,FAR,NLR levels among groups,logistic regression model was established to analyze the relationship between hs-CRP,FAR,NLR and prognosis of ACI+OSAHS patients.ROC curves were drawn to analyze the predictive value of hs-CRP,FAR and NLR for adverse events.Results Compared with the simple ACI group and control group,the levels of hs-CRP,FAR and NLR in ACI+OSAHS group were significantly increased(P<0.01).The levels of hs-CRP,FAR and NLR in the adverse events group were higher than without adverse events group(P<0.05).hs-CRP,FAR and NLR were the independent risk factors for adverse prognosis in ACI+OSAHS patients.According to ROC curve,the area under the curve(AUC)value of hs-CRP,FAR combined with NLR in predicting adverse events in ACI+OSAHS patients was 0.898(95%CI:0.774~0.973).The AUC value was higher than that predicted by single indicator and two indicators combined.Conclusion hs-CRP,FAR and NLR are highly expressed in ACI+OSAHS patients and can predict the prognosis of disease.The combined detection of the three indicators can improve the predictive value.

关 键 词：无症状脑梗死 阻塞性睡眠呼吸暂停低通气综合征 超敏C反应蛋白 纤维蛋白原/白蛋白比值 中性粒细胞/淋巴细胞比值 

分 类 号：R766[医药卫生—耳鼻咽喉科]