人体成分分析仪在筛查阻塞性睡眠呼吸暂停相关性高血压中的应用

Application of body component analyzer in the screening of obstructive sleep apnea-related hypertension

目的:应用人体成分分析仪测定阻塞性睡眠呼吸暂停(OSA)相关性高血压与原发性高血压患者的人体成分,并探讨其与呼吸暂停低通气指数(AHI)的关系。方法:选取154例OSA相关性高血压患者(其中48例轻度、54例中度、52例重度)和51例原发性高血压患者为研究对象,采用人体成分分析仪测量其人体成分。结果:OSA相关性高血压患者的体重指数、体脂肪率、内脏脂肪面积(VFA)、腰围和上臂围度高于原发性高血压患者(P均<0.05)。其中VFA(r=0.726)和腰围(r=0.630)与AHI强正相关(P均<0.01)。以VFA>91.10 cm^(2)筛查OSA相关性高血压的敏感度为61.7%,特异性为82.4%;以腰围>88.7 cm筛查OSA相关性高血压的敏感度为62.3%,特异性为78.4%。通过Logistic模型构建联合预测因子为-3.152+0.038×VFA+0.011×腰围,其筛查OSA相关性高血压的敏感度为82.1%,特异性为67.5%,截断值为1.105,受试者工作特征曲线下面积为0.795,诊断效能优于各项单独预测。结论:腹型肥胖是OSA相关性高血压发病的高危因素。采用人体成分分析仪,联合VFA和腰围对早期筛查OSA相关性高血压的高危人群具有重要意义。

Objective:To investigate the body component in patients with obstructive sleep apnea(OSA)-related hypertension and primary hypertension by using body component analyzer,and explore its relationship with apnea-hypopnea index(AHI).Methods:A total of 154 patients with OSA-related hypertension(mild,n=48;moderate,n=54;severe,n=52)and 51 patients with primary hypertension were selected as the research objects.Body component analyzer was used to measure the human component data.Results:Patients with OSA-related hypertension had higher body mass index,percentage body fat,visceral fat area(VFA),waistline,and arm circumference than patients with primary hypertension(all P<0.05).The VFA(r=0.726)and waistline(r=0.630)were strongly and positively correlated with AHI(all P<0.01).The sensitivity and specificity of VFA>91.10 cm^(2) for screening OSA-related hypertension were 61.7%and 82.4%respectively.The sensitivity and specificity of waistline>88.7 cm for screening OSA-related hypertension were 62.3%and 78.4%respectively.The combined predictor constructed by Logistic was-3.152+0.038×VFA+0.011×waistline,which showed sensitivity was 82.1%,specificity was 67.5%,cutoff value was 1.105,and the area under ROC curve was 0.795.The diagnostic efficiency of combined predictor was better than that of single index prediction.Conclusion:Abdominal obesity is a high risk factor of OSA-related hypertension.By using body component analyzer,the combination of VFA and waistline is of great significance for early screening the high-risk population of OSA-related hypertension.