血清C反应蛋白与白蛋白比值对睡眠呼吸暂停综合征严重程度的预测价值

Predictive value of C-reactive protein to albumin ratio for severity of obstructive sleep apnea syndrome

目的:探索C反应蛋白/白蛋白比值(C-reactive protein/albumin ratio,CAR)与阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)病情严重程度的相关性。方法:收集2012年1月1日至2019年12月31日在南京大学医学院附属口腔医院耳鼻喉科完成多导睡眠监测的门诊与住院患者,按照患者病情严重程度分级,评估不同病情严重程度患者CAR分布情况,与患者临床资料进行比较,采用logist ic回归模型进行多因素分析。结果:最终纳入223例患者,其中男159例,女64例,年龄24~69(49.80±12.83)岁。CAR在与轻度OSAS患者间比较,差异无统计学意义(P=0.291);中度与重度OSAS患者CAR均高于对照组(均P<0.001);轻度OSAS患者CAR小于中度与重度患者(均P<0.001);中度与重度患者相比,差异无统计学意义(P=0.496)。受试者操作特征(receiver operating character ist ic,ROC)曲线示CAR截断值为0.30,曲线下面积为0.849,敏感度为90.60%,特异度76.49%。结论:CAR升高可能对中重度OSAS患者病情严重程度具有预测价值。

Objective:To investigate the association between the C-reactive protein/albumin ratio(CAR)and the severity of obstructive sleep apnea syndrome(OSAS).Methods:From January 1,2012 to December 31,2019,patients who completed polysomnography in the Department of Otorhinolaryngology,Affiliated Stomatological Hospital of Nanjing University School of Medicine,were collected as research subjects.The severity of OSAS were graded.The distribution of CAR in patients with different severity of disease was evaluated and compared with the clinical data of patients.The logistic regression model was used for multivariate analysis.Results:Two hundred and twenty-three patients were included in final analysis.Of them,159 patients were male and 64 patients were female with mean age was 49.80±12.83 years(range,24-69 years).Statistical analysis showed that there was no significant difference in CAR between patients with mild OSAS(P=0.291).The ratio was higher in moderate and severe patients than control group(both P<0.001).The ratio was lower in mild patients than those with moderate and severe degree(both P<0.001).We failed to demonstrate the difference between moderate and severe patients(P=0.496).The receiver operating characteristic(ROC)curve indicated that the cutoff point of CAR was 0.30,and area under curve was 0.849 with a sensitivity of 90.60%and a specificity of 76.49%.Conclusion:Higher CAR may be predictive value for patients with moderate and severe OSAS.