AISI、SCI和BMI对阻塞性睡眠呼吸暂停的预测价值  

Predictive values of the aggregate index of systemic inflammation,systemic coagulation-inflammation index and body mass index in obstructive sleep apnea

作　　者：辛立红 张迁 杭文璐 陈雷 张茹玉 黄境滢 赵杰 Xin Lihong;Zhang Qian;Hang Wenlu;Chen Lei;Zhang Ruyu;Huang Jingying;Zhao Jie(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China;Department of Cardio-Pulmonary Circulation,Shanghai Pulmonary Hospital,Tongji University,Shanghai 200433,China)

机构地区：[1]徐州医科大学第二附属医院呼吸与危重症医学科,徐州221000 [2]同济大学附属上海市肺科医院肺循环科,上海200433

出　　处：《国际呼吸杂志》2025年第2期158-166,共9页International Journal of Respiration

基　　金：江苏省卫生健康委科研项目(Z2023023)。

摘　　要：目的探讨全身炎症综合指数(AISI)、系统凝血炎症指数(SCI)和身体质量指数(BMI)对阻塞性睡眠呼吸暂停(OSA)的预测价值。方法本研究为病例对照研究。采用非随机抽样的方法选取2021年3月至2024年1月期间在徐州医科大学第二附属医院完成多导睡眠监测的175例研究对象,根据是否诊断为OSA分为非OSA组(70例)与OSA组(105例)。收集并比较2组研究对象的一般资料(性别、年龄、BMI等),多导睡眠监测报告中的研究参数[平均血氧饱和度(MSpO_(2))、最低血氧饱和度(LSpO_(2))等],血液学指标(红细胞、白蛋白、血红蛋白、血小板体积分布宽度、乳酸脱氢酶、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)。计算并比较2组研究对象的AISI、SCI和系统免疫炎症指数(SII),采用单因素和多因素logistic回归分析影响OSA的危险因素。采用受试者操作特征曲线分析各指标的诊断效能。基于多因素logistic回归分析结果构建OSA发生的预测模型,并绘制受试者操作特征曲线和Hosmer-Lemeshow拟合优度检验曲线,评估模型的预测效果。结果本研究共纳入研究对象175例。其中男131例(74.9%),女44例(25.1%);年龄(51.18±13.52)岁,年龄范围18~78岁。非OSA组中男42例,年龄(49.57±13.87)岁;OSA组中男89例,年龄(52.25±13.24)岁。OSA组男性比例、BMI、AISI、SCI、SII均高于非OSA组,MSpO_(2)、LSpO_(2)均低于非OSA组,差异均有统计学意义(均P<0.05);2组年龄、高血压、糖尿病、冠状动脉粥样硬化性心脏病、红细胞、白蛋白、血红蛋白、血小板体积分布宽度、乳酸脱氢酶、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇比较差异均无统计学意义(均P>0.05)。多因素logistic回归分析结果显示,男性、年龄增长,以及BMI、AISI和SCI升高是OSA发生的独立危险因素。受试者操作特征曲线分析显示AISI、SCI、BMI诊断OSA的曲线下ObjectiveTo investigate the predictive values of the aggregate index of systemic inflammation(AISI),systemic coagulation-inflammation index(SCI)and body mass index(BMI)in obstructive sleep apnea(OSA).MethodsThis was a case-control study involving 175 subjects receiving polysomnography at the Second Affiliated Hospital of Xuzhou Medical University between March 2021 and January 2024 by non-randomized sampling.They were divided into the non-OSA group(n=70)and OSA group(n=105)according to whether they were diagnosed with OSA or not.General information(gender,age,BMI),study parameters(mean blood oxygen saturation[MSpO_(2)],lowest blood oxygen saturation[LSpO_(2)])and hematological indices(red blood cell,albumin,hemoglobin,platelet distribution width,lactate dehydrogenase,triglycerides,total cholesterol,high-density lipoprotein-cholesterol,and low-density lipoprotein-cholestero)were compared between the two groups.AISI,SCI,and systemic immune-inflammation index(SII)were calculated and compared between the two groups.Risk factors affecting OSA were analyzed using univariate and multivariate logistic regression.The diagnostic efficacy of each index was analyzed using the receiver operating characteristic(ROC)curves.A prediction model for the occurrence of OSA was constructed based on the results of multifactorial logistic regression analysis,and its performance was validated by the ROC curves and the Hosmer-Lemeshow goodness-of-fit test curves.ResultsA total of 175 participants were included in this study.Among them,131(74.9%)were males and 44(25.1%)were females,with a mean age of 51.18±13.52(18-78)years.There were 42 males in the non-OSA group and 89 in the OSA group.The mean age was 49.57±13.87 years in the non-OSA group and 52.25±13.24 years in the OSA group.The proportion of males,BMI,AISI,SCI,SII in the OSA group were significantly higher than those in the non-OSA group,and MSpO_(2) and LSpO_(2) were significantly lower than those in the non-OSA group(all P<0.05).Age,hypertension,diabetes mellitus,coronary ather

关 键 词：睡眠呼吸暂停 阻塞性 全身炎症综合指数 系统凝血炎症指数 系统免疫炎症指数 身体质量指数 列线图模型 

分 类 号：R54[医药卫生—心血管疾病]