摘要
目的观察阻塞性睡眠呼吸暂停综合征(OSAS)患者外周血中脂蛋白相关磷脂酶A2(Lp-PLA2)水平,探讨Lp-PLA2可否作为患者并发心血管疾病(CVD)的有效预测指标。方法选取238例疑似OSAS的患者为研究对象,根据呼吸暂停低通气指数(AHI)分为非OSAS组53例和OSAS组185例(轻度42例,中度68例,重度75例),其中OSAS患者并发CVD 74例。采用酶联免疫吸附实验(ELISA)测定外周血Lp-PLA2水平,并分析其与OSAS患者并发CVD的关系。结果合并CVD的OSAS患者年龄、AHI、氧减饱和度指数(ODI)、Lp-PLA2均高于不合并CVD的OSAS患者,差异有统计学意义(P<0.05)。在轻度、中度、重度OSAS患者中,合并CVD患者的Lp-PLA2水平高于不合并CVD患者,差异有统计学意义(P<0.05)。Lp-PLA2预测OSAS患者并发CVD的受试者工作特征(ROC)曲线的曲线下面积为0.804(0.740~0.859,P<0.001),截断值为235.1 ng/mL。多因素Logistic回归分析结果显示,AHI(OR=1.044,95%CI:1.025~1.063,P<0.001)、ODI(OR=1.035,95%CI:1.020~1.050,P<0.001)、Lp-PLA2(OR=2.700,95%CI:1.412~5.164,P=0.003)及高血压(OR=2.648,95%CI:1.384~5.067,P=0.003)是OSAS患者并发CVD的独立影响因素。结论Lp-PLA2可作为OSAS患者并发CVD的有效预测指标,Lp-PLA2>235.1 ng/mL提示患者并发CVD的风险较高。
Objective To observe the level of lipoprotein-associated phospholipase A2(Lp-PLA2)in peripheral blood of patients with obstructive sleep apnea syndrome(OSAS),and to explore whether Lp-PLA2 can be an effective predictor for patients with cardiovascular disease(CVD).Methods A total of 238 patients with suspected OSAS were selected as the research objects.According to the apnea hypopnea index(AHI),they were divided into non-OSAS group(n=53)and OSAS group(n=185)42 mild cases,68 moderate cases,and 75 severe cases).Among them,74 patients with OSAS were complicated with CVD.The level of Lp-PLA2 in peripheral blood was determined by enzyme-linked immunosorbent assay(ELISA),and its relationship with CVD in patients with OSAS was analyzed.Results The age,AHI,oxygen desaturation index(ODI),Lp-PLA2 of OSAS patients with CVD were significantly higher than those of OSAS patients without CVD(P<0.05).Among patients with mild,moderate and severe OSAS,the Lp-PLA2 level in patients with CVD was significantly higher than that in in patients without CVD(P<0.05).The area under receiver operating characteristic(ROC)curve of Lp-PLA2 for predicting CVD in OSAS patients was 0.804(0.740 to 0.859,P<0.001),and the cut-off value was 235.1 ng/m L.Multivariate Logistic regression analysis showed that AHI(OR=1.044,95%CI,1.025 to 1.063,P<0.001),ODI(OR=1.035,95%CI,1.020 to 1.050,P<0.001),Lp-PLA2(OR=2.700,95%CI,1.412 to 5.164,P=0.003)and hypertension(OR=2.648,95%CI,1.384 to 5.067,P=0.003)were independent influencing factors for CVD in OSAS patients.Conclusion Lp-PLA2 can be used as an effective predictor of OSAS patients complicated with CVD.Lp-PLA2>235.1 ng/m L indicates that patients have a higher risk of complicating CVD.
作者
许梅杰
钱文霞
许梅花
张洵
XU Meijie;QIAN Wenxia;XU Meihua;ZHANG Xun(Department of Respiratory and Critical Care Medicine,Zhangjiagang Hospital Affiliated to Soochow University,Zhangjiagang,Jiangsu,215600;Nanjing Medical University,Nanjing,Jiangsu,210009)
出处
《实用临床医药杂志》
CAS
2023年第3期6-10,共5页
Journal of Clinical Medicine in Practice
基金
国家自然科学基金项目(81800078)。
