老年阻塞性睡眠呼吸暂停综合征患者合并动脉粥样硬化的影响因素分析

Influencing Factors of Arteriosclerosis in Elderly Patients with Obstructive Sleep Apnea Syndrome

目的探讨老年阻塞性睡眠呼吸暂停综合征(OSAS)患者合并动脉粥样硬化(AS)的影响因素。方法选取2020年5月—2023年5月淮安市肿瘤医院收治的143例老年OSAS患者为研究对象。收集患者的临床资料、踝肱指数(ABI)、睡眠时间、STOP-Bang量表评分、呼吸暂停低通气指数(AHI)。根据脉搏波传导速度(PWV)将患者分为AS组(PWV≥1400 cm/s)和非AS组(PWV<1400 cm/s)。采用多因素Logistic回归分析探讨老年OSAS患者合并AS的影响因素。结果143例老年OSAS患者中,合并AS 61例,将其纳入AS组,将未合并AS的患者纳入非AS组。AS组有高血压史者占比、有糖尿病史者占比、有冠心病史者占比、BMI、收缩压、舒张压、TC、TG、空腹血糖、空腹胰岛素、糖化血红蛋白(HbA_(1c))、STOP-Bang量表评分、AHI高于非AS组,ABI低于非AS组(P<0.05)。多因素Logistic回归分析结果显示,高血压史〔OR=7.068,95%CI(3.109~16.066)〕、糖尿病史〔OR=30.472,95%CI(11.909~77.974)〕、冠心病史〔OR=3.953,95%CI(1.953~8.001)〕、BMI〔OR=1.638,95%CI(1.395~1.923)〕、收缩压〔OR=1.021,95%CI(1.001~1.042)〕、舒张压〔OR=1.127,95%CI(1.085~1.170)〕、TC〔OR=2.388,95%CI(1.650~3.456)〕、TG〔OR=13.488,95%CI(5.887~30.905)〕、空腹血糖〔OR=1.369,95%CI(1.052~1.781)〕、空腹胰岛素〔OR=1.172,95%CI(1.045~1.315)〕、HbA1c〔OR=2.827,95%CI(1.936~4.129)〕、ABI〔OR=0.117,95%CI(0.037~0.367)〕、STOP-Bang量表评分〔OR=1.659,95%CI(1.155~2.383)〕、AHI〔OR=1.162,95%CI(1.063~1.270)〕是老年OSAS患者合并AS的独立影响因素(P<0.05)。结论高血压史、糖尿病史、冠心病史、BMI、收缩压、舒张压、TC、TG、空腹血糖、空腹胰岛素、HbA_(1c)、ABI、STOP-Bang量表评分、AHI是老年OSAS患者合并AS的独立影响因素。

Objective To investigate the influencing factors of arteriosclerosis(AS)in elderly patients with obstructive sleep apnea syndrome(OSAS).Methods A total of 143 elderly patients with OSAS admitted to Huai'an Cancer Hospital from May 2020 to May 2023 were selected as the research subjects.The clinical data,ankle-brachial index(ABI),sleep time,STOP-Bang Scale score,and apnea-hypopnea index(AHI)of the patients were collected.The patients were divided into AS group[pulse wave velocity(PWV)≥1400 cm/s]and non-AS group(PWV<1400 cm/s)based on PWV.Multivariate Logistic regression analysis was used to explore the influencing factors of AS in elderly patients with OSAS.Results Among 143 elderly patients with OSAS,61 were complicated with AS and included in the AS group,while patients without AS were included in the non-AS group.The proportion of patients with hypertension history,proportion of patients with diabetes history,proportion of patients with coronary heart disease history,BMI,systolic pressure,diastolic pressure,TC,TG,fasting blood glucose,fasting insulin,glycosylated hemoglobin(HbA_(1c)),STOP-Bang Scale score,AHI in AS group were higher than those in non-AS group,ABI was lower than that in non-AS group(P<0.05).Multivariate Logistic regression analysis showed that history of hypertension[OR=7.068,95%CI(3.109-16.066)],history of diabetes[OR=30.472,95%CI(11.909-77.974)],history of coronary heart disease[OR=3.953,95%CI(1.953-8.001)],BMI[OR=1.638,95%CI(1.395-1.923)],systolic pressure[OR=1.021,95%CI(1.001-1.042)],diastolic pressure[OR=1.127,95%CI(1.085-1.170)],TC[OR=2.388,95%CI(1.650-3.456)],TG[OR=13.488,95%CI(5.887-30.905)],fasting blood glucose[OR=1.369,95%CI(1.052-1.781)],fasting insulin[OR=1.172,95%CI(1.045-1.315)],HbA1c[OR=2.827,95%CI(1.936-4.129)],ABI[OR=0.117,95%CI(0.037-0.367)],STOP-Bang Scale score[OR=1.659,95%CI(1.155-2.383)],AHI[OR=1.162,95%CI(1.063-1.270)]were the independent influencing factors of AS in elderly patients with OSAS(P<0.05).Conclusion History of hypertension,history of diabetes,history of coronary heart disease,BMI,systolic pressure,diastolic pressure,TC,TG,fasting blood glucose,fasting insulin,HbA_(1c),ABI,STOP-Bang Scale score,AHI are the independent influencing factors of AS in elderly patients with OSAS.