血清缺氧诱导因子-1α和高敏心肌肌钙蛋白I对慢性阻塞性肺疾病-阻塞性睡眠呼吸暂停重叠综合征患者发生心血管事件的预测价值

Predictive value of serum hypoxia-inducible factor-1αand high-sensitivity cardiac troponin I for cardiovascular events in patients with chronic obstructive pulmonary disease-obstructive sleep apnea overlap syndrome

目的探讨血清缺氧诱导因子(HIF)-1α和高敏心肌肌钙蛋白I(hs-cTnI)对慢性阻塞性肺疾病-阻塞性睡眠呼吸暂停重叠综合征(OS)患者发生心血管事件(CVE)的预测价值。方法对100例OS患者进行随诊,依据随访结果,将其分为CVE组19例和非CVE组81例。比较CVE组患者确诊发生CVE和非CVE组患者随访结束前最后1次复诊(前3个月内)血清HIF-1α和hs-cTnI水平。采用多因素logistic回归分析评估OS患者发生CVE的危险因素;采用受试者工作特征(ROC)曲线分析血清HIF-1α和hs-cTnI对OS患者发生CVE的预测价值。结果CVE组患者血清hs-cTnI及HIF-1α水平均明显高于非CVE组(P<0.05)。多因素logistic回归分析结果显示,HIF-1α升高和hs-cTnI升高均为OS患者发生CVE的独立危险因素(P<0.05)。ROC曲线分析结果显示,血清HIF-1α和hs-cTnI单独或联合预测OS患者3个月内发生CVE的ROC曲线下面积分别为0.698(95%CI 0.564~0.832)、0.686(95%CI 0.570~0.801)、0.822(95%CI 0.742~0.902)。结论血清HIF-1α和hs-cTnI水平升高是OS患者发生CVE的独立危险因素,其在预测OS患者近3个月内发生CVE的风险方面显示出良好的效能。

Objective To explore the predictive value of serum hypoxia-inducible factor(HIF)-1α and high-sensitivity cardiac troponin I(hs-cTnI)for cardiovascular events(CVE)in patients with chronic obstructive pulmonary disease-obstructive sleep apnea overlap syndrome(OS).Methods A total of 100 patients with OS were fellow up.According to the results of follow-up,they were divided into CVE group(19 cases)and non-CVE group(81 cases).Serum levels of HIF-1α and hs-cTnI of the last follow-up(within 3 months)when patients were diagnosed with CVE in CVE group and before the end of follow-up in non-CVE group were compared.Multivariate logistic regression analysis was used to evaluate risk factors of CVE in OS patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum HIF-1α and hs-cTnI on CVE in OS patients.Results Serum levels of hs-cTnI and HIF-1α in CVE group were significantly higher than those in non-CVE group(P<0.05).Multivariate logistic regression analysis showed that increased HIF-1α and hs-cTnI were independent risk factors for CVE in OS patients(P<0.05).Results of ROC curve analysis showed that area under ROC curve of serum HIF-1α and hs-cTnI alone or combined predicting CVE within 3 months in OS patients were 0.698(95%CI 0.564~0.832),0.686(95%CI 0.570~0.801),0.822(95%CI 0.742~0.902)respectively.Conclusion Increased serum HIF-1α and hs-cTnI levels are independent risk factors for CVE in OS patients,and they have shown good efficacy in predicting the risk of CVE in OS patients within 3 months.