PLR在OSAHS患者新发脑梗死中的临床应用价值

Clinical value of platelet⁃lymphocyte ratio for acute ischemic stroke in OSAHS patients

目的:探讨血小板-淋巴细胞比值(platelet lymphocyte ratio,PLR)在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者新发脑梗死中的变化,并分析PLR对OSAHS患者新发脑梗死的临床预测价值。方法:对155例OSAHS患者的病历资料进行回顾性分析;根据有无新发脑梗死分为单纯OSAHS组(A组93例)和OSAHS合并脑梗死组(B组62例),根据呼吸暂停低通气指数(apnea hypopnea index,AHI)将B组患者分为轻、中、重3级;收集两组的临床数据并采用SPSS 25.0软件分析两者的相关性以及PLR预测OSAHS患者新发脑梗死的效能。结果:(1)两组之间淋巴细胞计数、血小板计数、中性粒细胞计数、中性粒细胞-淋巴细胞比值(neutrophil lymphocyte ratio,NLR)、血氧饱和度<90%时间占监测总时间的百分比(TS90%)、PLR、AHI之间有显著差异(P<0.05);(2)B组患者PLR与AHI呈正相关(P<0.001);(3)Logistic回归分析示PLR是OSAHS患者新发脑梗死的独立危险因素(P<0.001);(4)ROC曲线分析显示血清PLR预测OSAHS患者新发脑梗死的最佳截断值为130.79,曲线下面积为0.888(95%CI:0.832~0.945)。结论:OSAHS合并脑梗死患者血清PLR值会随着AHI值的增加有递增趋势;而且PLR可能是OSAHS新发脑梗死的独立预测因子。

Objective:To investigate the changes of platelet⁃lymphocyte ratio(PLR)in obstructive sleep apnea hypopnea syndrome(OSAHS)patients with acute ischemic stroke and the clinical value of PLR.Methods:The case data of 155 patients with OSAHS were retrospectively analyzed.According to the presence or absence of acute ischemic stroke,patients were divided into simple OSAHS group(group A,n=93)and OSAHS combined with acute ischemic stroke group(group B,n=62).According to apnea hypopnea index(AHI),patients in group B were divided into three grades:mild,medium and severe.Clinical data of the two groups were collected and SPSS 25.0 software was used to analyze the correlation between the two groups and the efficacy of PLR in predicting acute ischemic stroke in OSAHS patients.Results:①There were significant differences in LYM,PLT,NEUT,neutrophil lymphocyte ratio(NLR),PLR,TS90%and AHI between the two groups(P<0.05).②PLR was positively correlated with AHI in group B(P=0.000).③Logistics analysis showed that PLR was an independent risk factor for acute ischemic stroke in OSAHS patients(P=0.000).④ROC curve analysis showed that the best cut⁃off value of serum PLR for predicting acute ischemic stroke in OSAHS patients was 130.79,and the area under the curve was 0.888(95%CI:0.832⁃0.945).Conclusions:High serum PLR is positively correlated with AHI in OSAHS patients with acute ischemic stroke,and PLR may be an independent predictor of acute ischemic stroke in OSAHS.