2020 年第 5 期 第 15 卷

单核细胞计数与高密度脂蛋白胆固醇比值对老年阻塞性睡眠呼吸暂停综合征患者心血管疾病的预测意义

Prediction of cardiovascular events in elderly patients with obstructive sleep apnea syndrome by monocytes to high density lipoprotein cholesterolratio

作者：杜江新1;达晶2;何尧利1;陈晓娟3

英文作者：Du Jiangxin1 Da Jing2 He Yaoli1 Chen Xiaojuan3

单位：1陕西省宝鸡市中心医院老年心脑血管病科721000；2陕西省宝鸡市中心医院内科721000；3西安医学院临床医学院710021

英文单位：1Department of Senile Cardiovascular Diseases Baoji Central Hospital Shaanxi Province Baoji 721000 China; 2Department of Internal Medicine Baoji Central Hospital Shaanxi Province Baoji 721000 China; 3Clinical Medical College of Xi′an Medical College Xi′an 710021 China

关键词：阻塞性睡眠呼吸暂停综合征；心血管事件；单核细胞计数与高密度脂蛋白胆固醇比值

英文关键词：Obstructivesleepapneasyndrome;Cardiovascularevents;Monocytestohigh-densitylipoproteincholesterolratio

• 摘要：

• 目的 探讨单核细胞计数与高密度脂蛋白胆固醇比值（MHR）对老年阻塞性睡眠呼吸暂停综合征（OSAS）患者心血管疾病（CVD）的预测意义。方法 选取2017年1月至2019年5月在陕西省宝鸡市中心医院睡眠呼吸研究中心进行睡眠研究的老年患者（≥60岁）210例作为研究对象。根据呼吸暂停低通气指数（AHI）将受试者分为对照组（AHI<5，35例）、轻度OSAS组（AHI 5～15，52例）、中度OSAS组（AHI>15～30，74例）和重度OSAS组（AHI>30，49例）。将心力衰竭、冠状动脉粥样硬化性心脏病和心律失常定义为CVD。使用多元Logistic回归分析模型评估各因素与CVD发生的相关性。结果 各组间年龄、男性患者比例、体重指数、CVD患者比例差异有统计学意义（均P＜0.05）。各组间单核细胞计数、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、MHR、AHI、最低血氧饱和度、平均血氧饱和度差异均有统计学意义（均P＜0.05）。随OSAS严重程度增加，CVD事件比例增高［对照组8.6%（3/35）、轻度OSAS组11.5%（6/52）、中度OSAS组35.1%（26/74）、重度OSAS组46.9%（23/49）］、MHR增高［对照组（10±3）、轻度OSAS组（11±4）、中度OSAS组（14±4），重度OSAS组（18±4）］（均P＜0.01）。多元Logistic回归分析发现年龄、AHI、高血压、糖尿病、MHR与老年OSAS患者CVD发生相关，其中MHR比值比为1.078，95%置信区间1.055～1.102，P＜0.001。结论CVD的发生与OSAS的严重程度呈正比，MHR可以作为老年OSAS患者发生CVD的独立预测因子。

  【关键词】

  
  

• Objective To investigate the value of monocytes to high density lipoprotein cholesterol(MHR) ratio in predicting cardiovascular disease(CVD) in elderly patients with obstructive sleep apnea syndrome(OSAS). Methods Totally 210 elderly patients(≥60 years old) who visited Sleep Breathing Center of Baoji Central Hospital, Shaanxi Province from January 2017 to May 2019 were divided into control group［apnea hypoventilation index(AHI)<5, 35 cases］, mild OSAS group(AHI 5-15, 52 cases), moderate OSAS group(AHI>15-30, 74 cases) and severe OSAS group(AHI>30, 49 cases). Heart failure, coronary heart disease and arrhythmia were defined as CVD. Correlation between CVD and relevant risk factors was analyzed by multivariate logistic regression. Results There were significant differences in age, sex, body mass index, proportion of CVD patients, monocyte count, total cholesterol, triacylglycerol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, MHR, AHI, the lowest oxygen saturation and the average oxygen saturation among the 4 groups(all P＜0.05). CVD events increased with the severity of OSAS［8.6%(3/35) in control group, 11.5%(6/52) in mild OSAS group, 35.1%(26/74) in moderate OSAS group, 46.9%(23/49) in severe OSAS group］(P＜0.01). MHR increased with the severity of OSAS［(10±3) in control group, (11±4) in mild OSAS group, (14±4) in moderate OSAS group, (18±4) in severe OSAS group］(P＜0.01). Multivariate logistic regression analysis showed that age, AHI, hypertension, diabetes and MHR（odds ratio=1.078, 95% confidence interval: 1.055-1.102, P＜0.001） were related with the occurrence of CVD in elderly OSAS patients. Conclusions The incidence of CVD is related to the severity of OSAS. MHR can be used as an independent predictor of CVD in elderly patients with OSAS.