血清鸢尾素水平对高血压合并重度阻塞性睡眠呼吸暂停综合征的诊断价值  

Diagnostic value of serum irisin levels in hypertensive patients with severe obstructive sleep apnea syndrome

作　　者：吉娜·伊力 姚晓光[1] 李南方[1] JINA YILI;YAO Xiao-guang;LI Nan-fang(Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院高血压中心、新疆高血压研究所、国家卫生健康委员会高血压诊疗研究重点实验室,830001

出　　处：《中国实用医药》2024年第7期91-95,共5页China Practical Medicine

基　　金：新疆维吾尔自治区自然科学基金面上项目(项目编号:2021D01C173);新疆维吾尔自治区人民医院院内项目(项目编号:20190419)。

摘　　要：目的观察血清鸢尾素(Irisin)水平对高血压合并重度阻塞性睡眠呼吸暂停综合征(OSAS的诊断价值。方法156例高血压患者,根据呼吸暂停低通气指数(AHI)结果分为重度OSAS组(79例)和非重度OSAS组(77例)。收集两组基线资料,均进行多导睡眠监测(PSG)、动态血压监测,测定血清鸢尾素水平。比较两组基线资料、血清鸢尾素水平,分析血清鸢尾素水平与各项指标的相关性、血清鸢尾素水平的受试者工作特征曲线(ROC)。结果两组患者的体质量指数(BMI)、诊室收缩压(SBP)、诊室舒张压(DBP)及24 h平均SBP、24 h平均DBP比较均无显著差异(P>0.05)。重度OSAS组患者的年龄、男性占比、腹围、颈围、AHI均高于非重度OSAS组,平均血氧饱和度(MSpO_(2))、最低血氧饱和度(LSpO_(2))低于非重度OSAS组,差异均有统计学意义(P<0.05)。156例患者中位血清鸢尾素水平为25.17 ng/ml,重度OSAS组中位血清鸢尾素水平为14.94(4.45,28.93)ng/ml,非重度OSAS组中位血清鸢尾素水平为42.34(21.93,74.31)ng/ml。两组患者中位血清鸢尾素水平比较差异有统计学意义(P<0.001)。156例高血压患者中,血清鸢尾素水平与年龄、AHI呈负相关(r=-0.175、-0.359,P=0.029、0.000<0.05),与MSpO_(2)呈正相关(r=0.188,P=0.020<0.05)。采用ROC曲线分析血清鸢尾素浓度临界值为38.07 ng/ml,曲线下面积(AUC)为0.761,其敏感度为86.08%(68/79),特异度为61.04%(47/77),阳性预测值为69.39%(68/98),阴性预测值分别为81.03%(47/58)。结论高血压人群中,OSAS患者血清鸢尾素浓度与OSAS的严重程度呈负相关;且血清鸢尾素水平可作为重度OSAS患者的诊断指标。Objective To observe the diagnostic value of serum irisin levels in hypertensive patients with severe obstructive sleep apnea syndrome(OSAS).Methods A total of 156 hypertensive patients were selected.According to apnea hypopnea index(AHI),the patients were divided into severe OSAS group(79 cases)and non-severe OSAS group(77 cases).The baseline data,polysomnography(PSG)and ambulatory blood pressure monitoring(ABPM)were collected and serum irisin levels were measured.The baseline data and serum irisin levels of the two groups were compared,and the correlation between serum irisin levels and various indicators,as well as receiver operating characteristic(ROC)curve of serum irisin levels were analyzed.Results There were no significant differences in body mass index(BMI),office systolic blood pressure(SBP),office diastolic blood pressure(DBP)and 24-h mean SBP and DBP between the two groups(P>0.05).The age,male proportion,abdominal circumference,neck circumference,AHI in severe OSAS group were higher than those in non-severe OSAS group;the severe OSAS group had lower lowest oxygen saturation(LSpO_(2))and mean blood oxygen saturation(MSpO_(2))than those in non-severe OSAS group;the differences were statistically significant(P<0.05).The median serum irisin level in 156 patients was 25.17 ng/ml,the median serum irisin level in the severe OSAS group was 14.94(4.45,28.93)ng/ml,and the median serum irisin level in the non-severe OSAS group was 42.34(21.93,74.31)ng/ml.The median serum irisin level was significantly different between the two groups(P<0.001).In 156 hypertensive patients,serum irisin level was negatively correlated with age and AHI(r=-0.175,-0.359;P=0.029,0.000<0.05),and was positively correlated with MSpO_(2)(r=0.188,P=0.020<0.05).ROC curve analysis showed that the critical value of serum irisin concentration was 38.07 ng/ml,the area under the curve(AUC)was 0.761,the sensitivity was 86.08%(68/79),the specificity was 61.04%(47/77),the positive predictive value was 69.39%(68/98),and the negative predictive value

关 键 词：阻塞性睡眠呼吸暂停综合征 高血压 血清鸢尾素 

分 类 号：R766[医药卫生—耳鼻咽喉科] R544.1[医药卫生—临床医学]