摘要
目的 :探讨血清非对称二甲基精氨酸(asymmetric dimethyl arginine,ADMA)、一氧化氮(nitric oxide,NO在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)相关的心脑血管疾病诊断中的应用价值。方法:选取2016年1月至2018年12月我院耳鼻喉科收治的126例OSAHS患者作为研究对象,同期64名体检健康者作为对照组。比较2组的临床实验室检查指标及血清学指标;分别采用酶联免疫吸附法和比色法检测血清ADMA、NO水平。应用Logistic回归分析影响OSAHS的危险因素,采用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)评价血清ADMA、NO对OSAHS的诊断价值。结果:2组的年龄、性别、体质量指数、饮酒史、吸烟史、高血压史等一般资料比较差异无统计学意义(均P>0.05);研究组收缩压、舒张压、红细胞、红细胞比容(hematocrit,HCT)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(lowdensity lipoprotein-cholesterol,LDL-C)、尿酸(uric acid, UA)和ADMA明显高于对照组,而高密度脂蛋白胆固醇(highdensity lipoprotein-cholesterol,HDL-C)、NO水平显著低于对照组(均P<0.05)。多因素Logistic回归分析显示,血清ADMA和NO是OSAHS相关的心脑血管疾病的独立危险因素(均P<0.05)。ROC曲线分析显示,血清ADMA诊断OSAHS相关的心脑血管疾病曲线下面积(area under curve,AUC)为0.893,灵敏度为69.8%,特异度为98.4%;血清NO诊断OSAHS的AUC为0.828,灵敏度为65.1%,特异度为85.9%;ADMA/NO诊断的AUC为0.919,灵敏度为77.0%,特异度为96.9%;两者联合诊断AUC为0.940,灵敏度为85.7%,特异度为90.6%,明显优于ADMA、NO单独检测(P<0.05)。结论:OSAHS患者血清ADMA水平升高,NO水平降低,两者水平变化对于OSAHS相关的心脑血管疾病有较好的临床诊断价值。
Objective To evaluate the clinical diagnostic value of serum asymmetric dimethyl arginine(ADMA) and nitric oxide(NO) in obstructive sleep apnea hypopnea syndrome(OSAHS) related cardiovascular and cerebrovascular diseases. Methods One hundred and twenty-six patients with OSAHS in the Department of Otolaryngology of Shaanxi Provincial People’s Hospital from January 2016 to December 2018 were enrolled as the study subjects, and 64 healthy subjects in the same period from the hospital were selected as the control group. The clinical laboratory examination and serological indicators were compared between the two groups. The serum ADMA and NO level were detected by enzyme linked immunosorbent assay(ELISA) and colorimetry respectively. The risk factors associated with OSAHS were analyzed by Logistic regression analysis, and the diagnostic value of serum ADMA and NO for OSAHS was evaluated by receiver operating characteristic(ROC) curve. Results There were no significant difference in age, sex, body mass index, history of alcohol consumption, smoking and hypertension between the two groups(all P>0.05). The indexes including systolic blood pressure(SBP), diastolic blood pressure(DBP), red blood cell(RBC), hematocrit(HCT), total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), uric acid(UA) and ADMA in the OSAHS group were significantly higher than those of the control group, however, the high density lipoprotein cholesterol(HDL-C) and NO level were significantly lower than the control group(all P<0.05). Logistic multivariate regression analyses indicated that the serum ADMA and NO were independent risk factors for OSAHS-related cardiovascular and cerebrovascular diseases(all P<0.05). The ROC curve analysis showed that the area under curve(AUC) of serum ADMA was 0.893, the sensitivity was 69.8%, and the specificity was 98.4%. The AUC of serum NO for OSAHS identification was 0.828, the sensitivity was 65.1%, and the specificity was85.9%. The AUC of ADMA/NO diagnosis was 0.919, the sensitivity
作者
王晋平
袁丽洁
丰航
张海祥
WANG Jinping;YUAN Lijie;FENG Hang;ZHANG Haixiang(Department of Otolaryngology,Shaanxi Provincial People’s Hospital,Xi'an 710068,China;Department of Medical Office Infection Management,Shaanxi Provincial People’s Hospital,Xi'an 710068,China;Department of Pharmacy,Shaanxi Provincial People’s Hospital,Xi'an 710068,China;Central Laboratory,Shaanxi Provincial People’s Hospital,Xi'an 710068,China)
出处
《内科理论与实践》
2020年第6期391-395,共5页
Journal of Internal Medicine Concepts & Practice
基金
陕西省自然科学基础研究计划项目(项目编号:2018JM7145)。
