血清鸢尾素在诊断阻塞性睡眠呼吸暂停综合征患者中的价值分析

邱峰; 宋春艳; 秦福创; 田斯琦; 黄蓉; 马希列; 曾剑平

doi:10.16766/j.cnki.issn.1674-4152.001731

血清鸢尾素在诊断阻塞性睡眠呼吸暂停综合征患者中的价值分析

doi: 10.16766/j.cnki.issn.1674-4152.001731

1.
树兰(杭州)医院急诊医学科，浙江杭州 310006
2.
树兰(杭州)医院脑科中心，浙江杭州 310006
3.
树兰(杭州)医院病理科，浙江杭州 310006
4.
杭州市红十字会医院骨科, 浙江杭州 310003
5.
浙江大学附属第一医院神经外科，浙江杭州 310003

基金项目:

浙江省基础公益研究计划项目 LGF19H090007

详细信息

通讯作者:
邱峰，E-mail: 787177112@qq.com

中图分类号: R56 R446
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- 文章访问数: 106
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- 被引次数: 0
出版历程
- 收稿日期: 2020-04-16
- 网络出版日期: 2022-02-19

Analysis of the value of serum irisin in the diagnosis of obstructive sleep apnea syndrome

1.
Department of Emergency Medicine, Shulan (Hangzhou) Hospital, Hangzhou, Zhejiang 310006, China

摘要

摘要: 目的探讨阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome，OSAS)程度与血清鸢尾素水平的相关性。方法选取2017年5月—2018年12月期间树兰(杭州)医院收治确诊的96例OSAS患者纳入OSAS组，并根据呼吸暂停低通气指数分为轻度30例、中度30例、重度36例；另选取30名健康体检者纳入对照组。采用多导睡眠监测仪检测呼吸暂停低通气指数、最低血氧饱和度及最长呼吸暂停时间，酶联免疫吸附法检测血清鸢尾素水平。结果 OSAS组血清鸢尾素水平[(1.43±0.28)ng/mL]、最低血氧饱和度[(70.47±3.81)%]明显低于对照组[(2.82±0.54)ng/mL和(94.58±3.21)%]，呼吸暂停低通气指数[(27.64±3.29)次/h] 明显多于对照组[(2.37±1.08)次/h]，最长呼吸暂停时间[(37.45±4.23)s]明显长于对照组[(1.73±0.65)s]，差异均有统计学意义(均P < 0.05)。随着病情的严重程度增加，血清鸢尾素水平、最低血氧饱和度降低，最长呼吸暂停时间升高。OSAS组呼吸暂停低通气指数、最长呼吸暂停时间均与血清鸢尾素水平呈负相关(r=-0.717、-0.765，均P < 0.05)，最低血氧饱和度与血清鸢尾素水平呈正相关(r=0.747，P < 0.05)。以多导睡眠监测为金标准，血清鸢尾素诊断OSAS的敏感度为68.8%，特异度为93.3%。结论 OSAS患者的血清鸢尾素水平与OSAS的病情程度有关，OSAS越严重，血清鸢尾素水平越低。
- 阻塞性睡眠呼吸暂停综合征 /
- 鸢尾素 /
- 呼吸暂停低通气指数 /
- 最低血氧饱和度 /
- 最长呼吸暂停时间
Abstract: Objective To investigate the correlation between the degree of obstructive sleep apnea syndrome (OSAS) and the level of irisin in serum. Methods Ninety-six OSAS patients diagnosed in Shulan (Hangzhou) Hospital from May 2017 to December 2018 were selected in the OSAS group, and according to the apnea hypopnea index, they were divided into mild (30 cases), moderate (30 cases) and severe (36 cases), another 30 healthy people were selected as the control group. The indexes of apnea hypopnea, the lowest oxygen saturation and the longest time of apnea were measured by polysomnography. The level of serum irisin was measured by enzyme-linked immunosorbent assay. Results The serum irisin level [(1.43±0.28) ng/mL], the lowest oxygen saturation [(70.47±3.81)%] in the OSAS group were significantly lower than those in the control group [(2.82±0.54) ng/mL and (94.58±3.21)%], the apnea hypopnea index [(27.64±3.29) times/h], the longest apnea time [(37.45±4.23) s] were significantly higher than those in the control group [(2.37±1.08) times/h and (1.73±0.65) s], the difference was statistically significant (all P < 0.05). With the increase of the severity of the disease, the level of serum irisin, the lowest oxygen saturation and the longest apnea time decreased. In the OSAS group, the index of apnea hypopnea and the longest time of apnea were negatively correlated with the level of serum irisin (r=-0.717, -0.765; all P < 0.05), and the lowest oxygen saturation was positively correlated with the level of serum irisin (r=0.747, P < 0.05). According to the gold standard of polysomnography, the sensitivity and specificity of irisin in the diagnosis of OSAS were 68.8% and 93.3%, respectively. Conclusion The serum irisin level of OSAS patients is related to the severity of OSAS. The more severe OSAS, the lower the serum irisin level.
- Obstructive sleep apnea syndrome /
- Irisin /
- Apnea hypopnea index /
- Lowest oxygen saturation /
- Longest apnea time

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图 1 血清鸢尾素水平与呼吸暂停低通气指数的相关性

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图 2 血清鸢尾素水平与最低血氧饱和度的相关性

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图 3 血清鸢尾素水平与最长呼吸暂停时间的相关性

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图 4 血清鸢尾素对OSAS诊断价值的ROC曲线

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表 1 OSAS组与对照组一般资料比较

组别	例数	性别 (男/女，例)	年龄 (x±s，岁)	体重指数 (x±s)
OSAS组	96	63/33	46.4±8.6	26.2±3.6
对照组	30	20/10	45.2±8.4	25.7±3.3
统计量		0.011^a	0.671^b	0.677^b
P值		0.916	0.504	0.500
注：^a为χ²值，^b为t值。

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表 2 OSAS组与对照组血清鸢尾素水平及临床相关指标比较(x±s)

组别	例数	血清鸢尾素水平 (ng/mL)	呼吸暂停低通气指数(次/h)	最低血氧饱和度(%)	最长呼吸暂停时间(s)
OSAS组	96	1.43±0.28	27.64±3.29	70.47±3.81	37.45±4.23
对照组	30	2.82±0.54	2.37±1.08	94.58±3.21	1.73±0.65
t值		18.560	41.280	31.340	45.960
P值		＜0.001	＜0.001	＜0.001	＜0.001

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表 3 不同程度OSAS组血清鸢尾素水平及临床相关指标比较(x±s)

组别	例数	血清鸢尾素水平 (ng/mL)	最低血氧饱和度(%)	最长呼吸暂停时间(s)
轻度OSAS组	30	1.83±0.03	86.25±2.21	25.37±1.58
中度OSAS组	30	1.05±0.03^a	74.63±3.69^a	34.26±4.09^a
重度OSAS组	36	0.54±0.04^ab	61.24±4.95^ab	43.22±5.37^ab
F值		11 173.235	327.822	149.164
P值		< 0.001	< 0.001	< 0.001
注：与轻度OSAS组比较，^aP < 0.05；与中度OSAS组比较，^bP < 0.05。

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