CAR、NLR在阻塞性睡眠呼吸暂停低通气综合征合并高血压诊断中的价值

Roles of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio in predicting obstructive sleep apnea hypopnea syndrome with hypertension

目的探讨C反应蛋白/白蛋白比值(CAR)、中性粒细胞/淋巴细胞比值(NLR)在诊断阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者合并高血压中的价值。方法选取2019年10月—2022年10月三亚中心医院OSAHS患者120例,根据住院期间和出院随访6个月内是否发生高血压分为合并高血压组和单纯OSAHS组。收集所有患者的一般资料,并检测CAR和NLR。采用二元Logsitic回归分析评估OSAHS患者合并高血压的危险因素。采用受试者工作特征(ROC)曲线评价各项指标单项检测和联合检测预测OSAHS患者合并高血压的效能。结果120例OSAHS患者有81例(67.5%)合并高血压。合并高血压组体重指数(BMI)、NLR、CAR水平和糖尿病史、高脂血症、中度病情和重度病情所占比例显著高于单纯OSAHS组(P<0.05)。NLR、CAR水平随OSAHS患者高血压分级的增高而升高(P<0.05)。BMI升高、合并糖尿病、合并高脂血症、中重度OSAHS、NLR升高和CAR升高是OSAHS患者合并高血压的危险因素(P<0.05)。CAR、NLR单项检测和联合检测(2项指标任意1项阳性即为联合检测阳性)预测OSAHS患者合并高血压的ROC曲线下面积(AUC)分别为0.696、0.654、0.802,联合预测模型的AUC为0.845。结论CAR、NLR可预测OSAHS患者合并高血压,两者联合临床指标对OSAHS合并高血压的预测效能更高。

Objective To investigate the roles of C-reactive protein/albumin ratio(CAR)and neutrophil/lymphocyte ratio(NLR)in the prediction of obstructive sleep apnea hypopnea syndrome(OSAHS)with hypertension.Methods From October 2019 to October 2022,120 patients with OSAHS in Sanya Central Hospital were enrolled and classified into hypertension group and OSAHS group according to whether they were complicated with hypertension or not during hospitalization and follow-up for 6 months after discharge.The general data were collected,and CAR and NLR were determined and calculated.Bivariate Logistic regression analysis was used to evaluate the risk factors of hypertension in OSAHS patients.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of single and combined determinations of various indicators in the prediction of OSAHS with hypertension.Results Of 120 OSAHS patients,81 cases(67.5%)were complicated with hypertension.The body mass index(BMI),NLR,CAR,diabetes mellitus history,hyperlipidemia and moderate to severe OSAHS proportion in hypertension group were higher than those in OSAHS group(P<0.05).NLR and CAR were increased with the increase of hypertension grade of OSAHS patients(P<0.05).Increased BMI,diabetes mellitus,hyperlipidemia,moderate to severe OSAHS,NLR and CAR were risk factors for hypertension in OSAHS patients(P<0.05).The areas under curves(AUC)for predicting OSAHS patients with hypertension were 0.696,0.654 and 0.802,respectively,for the single and combined determinations of CAR and NLR(positive for either of the 2 indicators).The AUC of the prediction model was 0.845.Conclusions CAR and NLR play roles in the prediction of OSAHS with hypertension,and the combined prediction model is effective in the prediction of OSAHS with hypertension.