AIP联合AHI对OSAHS患者并发冠心病的预测价值

The predictive value of AIP combined with AHI for coronary heart disease in OSAHS patients

目的分析血浆致动脉硬化指数(AIP)及呼吸暂停低通气指数(AHI)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者并发冠心病的相关性及预测价值。方法回顾性收集2018年1月—2023年1月在黄石市中心医院第一次行冠状动脉造影检查的OSAHS患者136例临床资料,按是否诊断冠心病将患者分为冠心病组59例和非冠心病组77例,比较2组AHI与AIP差异,采用Pearson相关性分析AHI与AIP相关性,Logistic回归分析OSAHS合并冠心病的影响因素,采用受试者工作特征曲线(ROC)进行预测价值分析。结果冠心病组OSAHS患者AHI、AIP均高于非冠心病组(t=7.393、4.314,P均<0.001)。AHI与AIP呈正相关(r=0.254,P=0.003)。病程长、BMI大、AHI高、AIP高是OSAHS并发冠心病的独立危险因素[OR(95%CI)=1.264(1.044~1.532)、1.577(1.174~2.119)、1.199(1.107~1.298)、3.165(1.039~5.312)],HDL-C升高为独立保护因素[OR(95%CI)=0.724(0.605~0.873)]。AHI、AIP及二者联合预测OSAHS的AUC分别为0.835、0.838、0.891,二项联合的AUC大于二者单独检测(Z=2.498、2.108,P=0.013、0.035)。结论高水平AIP及AHI是OSAHS患者合并冠心病的独立危险因素,两者联合可有效提高OSAHS患者合并冠心病的预测作用。

Objective To analyze the correlation and predictive value of plasma atherosclerotic index(AIP)and apnea hypopnea index(AHI)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)complicated with coronary heart disease.Methods Collection of clinical data from 136 OSAHS patients who underwent their first coronary angiography examination at Huangshi Central Hospital from January 2018 to January 2023.Patients were divided into a coronary heart disease group of 59 cases and a non coronary heart disease group of 77 cases based on whether coronary heart disease was diagnosed.The differences between AHI and AIP between the two groups were compared.Pearson correlation analysis was used to analyze the correlation between AHI and AIP,and logistic regression analysis was used to analyze the influencing factors of OSAHS combined with coronary heart disease,Predictive value analysis was conducted using the receiver operating characteristic curve(ROC).Results The AHI and AIP of OSAHS patients in the coronary heart disease group were higher than those in the non coronary heart disease group(t=7.393,4.314,P<0.001).AHI is positively correlated with AIP(r=0.254,P=0.003).Long disease course,high BMI,AHI,and AIP are independent risk factors for OSAHS complicated with coronary heart disease[OR(95%CI)=1.264(1.044-1.532),1.577(1.174-2.119),1.199(1.107-1.298),3.165(1.039-5.312)],high LDL-C is independent protective factor[OR(95%CI)=0.724(0.605-0.873)];The AUC of OSAHS predicted by AHI,AIP,and their combination were 0.835,0.838,and 0.891,respectively.The AUC of the combination of the two was greater than that detected by the two alone(Z=2.498,2.108,P=0.013,0.035).Conclusion High levels of AIP and AHI are independent risk factors for coronary heart disease in OSAHS patients,and their combination can effectively improve the predictive value of coronary heart disease in OSAHS patients.