阻塞型睡眠呼吸暂停低通气综合征患者血中性粒细胞/淋巴细胞比值的临床意义

Levels and clinical significances of serum neutrophil to lymphocyte ratio (NLR) in patients with obstructive sleep apnea hypopnea syndrome

目的:探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)患者血中性粒细胞/淋巴细胞比值(NLR)水平及临床意义。方法:根据呼吸暂停低通气指数(AHI),将66例OSAHS患者分为轻度组(n=16)、中度组(n=15)和重度组(n=35),选择25例健康体检者作为对照组。检测并比较4组研究对象最低血氧饱和度(LSaO2)、血白细胞、中性粒细胞、淋巴细胞、血小板、平均血小板体积、红细胞分布宽度、NLR和血小板/淋巴细胞比值(PLR)水平,分析AHI、LSaO2与NLR的相关性,并绘制NLR预测OSAHS的受试者工作特征(ROC)曲线。结果:与对照组比较,重度组血白细胞、中性粒细胞和NLR水平均显著升高,中度组血白细胞水平升高(P<0.05),各OSAHS组血淋巴细胞、血小板、PLR、平均血小板体积、红细胞分布宽度水平的差异无统计学意义(P>0.05);与轻度组比较,重度组血白细胞、中性粒细胞和NLR水平升高(P<0.05);3组OSAHS组间血淋巴细胞、血小板、PLR、平均血小板体积、红细胞分布宽度水平的差异无统计学意义(P>0.05);OSAHS患者血NLR水平与AHI呈正相关(r=0.259 4,P<0.05),与LSaO2呈显著负相关(r=-0.242 3,P<0.05);NLR预测OSAHS的ROC曲线下面积(AUC)为0.667 3,敏感性为66.67%,特异性为60%,95%可信区间(95%CI)为0.546 8~0.787 7,NLR的诊断阈值为1.54。结论:OSAHS患者血NLR水平随AHI和缺氧程度的增加而升高,NLR是预测OSAHS的较好指标,可用于辅助评估患者炎症反应程度。

Objective: To investigate the levels and clinical significances of serum neutrophil to lymphocyte ratio(NLR) in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods: According to the apnea hypopnea index(AHI), 66 patients with OSAHS were divided into mild group(n=16), moderate group(n=15) and severe group(n=35). Twenty-five healthy people were selected as a control group. The lowest oxygen saturation(LSaO2), white blood cells, neutrophils, lymphocytes, platelets, mean platelet volume, red blood cell distribution width, NLR,and platelets/lymphocyte ratio(PLR) levels were detect and compared among the four groups. The correlation between AHI, LSaO2, and NLR were analyzed. The ROC curve of NLR was drawn to predictive OSAHS.Results: Compared with the control group, the white blood cells, neutrophils, and NLR levels in the severe group were significantly increased. The levels of white blood cells were increased in the moderate group(P<0. 05). There was no significant difference in the levels of blood lymphocytes, platelets, PLR, mean platelet volume, and red blood cell distribution width between the OSAHS groups(P>0. 05). Compared with those in mild OSAHS group, the levels of white blood cells, neutrophils,and NLR were increased in the severe group(P<0. 05). There was no significant difference in the levels of blood lymphocytes, platelets, PLR, mean platelet volume and red blood cell distribution between the three different groups of OSAHS(P>0. 05). The blood NLR level of OSAHS patients was positively correlated with AHI(r=0. 2594, P<0. 05), and negatively correlated with LSaO2(r=-0. 242 3, P<0. 05). The area under the ROC curve of NLR predicting OSAHS was 0. 667 3, the sensitivity was 66. 67%, the specificity was 60%, the 95% confidence interval was 0. 546 8-0. 787 7,and the diagnostic threshold of NLR was 1. 54.Conclusion: There was a possible corrlation between NLR and OSAHS, and NLR could serve as a good indicator in the diagnosis and treatment of OSAHS.