中性粒细胞/淋巴细胞比值及血小板相关指标与OSAS 患者严重程度的相关性研究

NLR,PLR and MPV related to the severity of obstructive sleep apnea syndrome

目的探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、血小板平均体积(MPV)与阻塞性睡眠呼吸暂停低通气综合征(OSAS)严重程度的相关性。方法采用回顾性病例对照研究,应用多导睡眠监测仪(PSG)记录患者相关睡眠参数,根据呼吸紊乱指数(AHI)分为轻、中、重3组,并检测外周血中性粒细胞(WBC)、淋巴细胞计数(LC)、血小板计数(PLT)、血小板分布宽度(PDW)、NLR、PLR、MPV等相关资料。比较各组上述指标之间有无差异并进行相关性分析,以ROC曲线评价各指标对OSAS患者诊断的价值。结果各组间BMI、TC、TG、LDL、夜间平均心率、NLR、PDW、MPV、最低氧饱和度、平均氧饱和度之间差异存在统计学意义(均P<0.05),NLR、PDW、MPV与AHI之间存在显著相关(均P<0.05),PLR与AHI之间无明显相关性(均P>0.05),NLR预测OSAS的ROC曲线下面积为0.836,最佳截断值为1.685,灵敏度为65.5%、特异度为92.3%、阳性预测值为96.5%、阴性预测值为45.3%。结论 NLR、PDW、MPV对OSAS患者严重程度的判断存在重要的预测价值。

Objective To explore the role of neutrophil-to-lymphocyte ratio(NLR),Platelet-to-lymphocyte ratio(PLR),and mean platelet volume(MPV)in the diagnosis and judgment of the severity of obstructive sleep apnea syndrome(OSAS).Methods A retrospective case-control study was conducted among the patients with OSAS.The sleep parameters were recorded by using a polysomnography(PSG).The patients were assigned into mild,moderate and serious groups according to the apnea hypopnea index(AHI).The peripheral blood neutrophil count(WBC),lymphocyte count(LC),platelet count(PLT),platelet distribution width(PDW),NLR,PLR,MPV and other related data were detected and compared among the four groups.The correlation analysis of NLR,PLR,MPV and AHI was carried out by Pearson test,and the value of each index to the diagnosis of OSAS patients was evaluated by ROC curve.Results There were statistical differences in BMI,TC,TG,LDL,nocturnal mean heart rate,NLR,PDW,MPV,minimum oxygen saturation and mean oxygen saturation among the four groups(P<0.05).There was a significant correlation between NLR,PDW,MPV and AHI,P<0.05,however,there was no significant correlation between PLR and AHI(P>0.05).ROC curves analysis showed that the area under the curve(AUC)score was 0.836 for NLR,the best cutoff for ROC was 1.685,sensitivity was 65.5%,specificity was 92.3%,positive predictive value was 96.5%,and negative predictive value was 45.3%.Conclusion NLR,PDW and MPV play an important role in the judgment of the severity of OSAS.