血脂、血小板参数、HOMA-IR与阻塞性睡眠呼吸暂停低通气综合征合并高血压患者PSG参数的相关性及其预测价值研究

摘要 目的：探讨血脂、血小板参数、稳态模型胰岛素抵抗指数（HOMA-IR）与阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并高血压患者多导睡眠图（PSG）参数的相关性及其预测价值。方法：选择2020年1月至2022年11月徐州医科大学附属沭阳医院收治的163例OSAHS患者,根据是否合并高血压将其分为单纯OSAHS组（78例）及高血压组（85例）,检测两组血脂、血小板参数、HOMA-IR、PSG参数;Pearson相关性分析血脂、血小板参数、HOMA-IR与PSG参数的相关性;多因素Logistic回归分析OSAHS合并高血压的危险因素;受试者工作特征（ROC）曲线分析血脂、血小板参数、HOMA-IR预测OSAHS合并高血压的价值。结果：高血压组甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、平均血小板体积（MPV）、HOMA-IR、微觉醒指数（MAI）、呼吸暂停低通气指数（AHI）、氧减指数（ODI）高于单纯OSAHS组（P＜0.05）,高密度脂蛋白胆固醇（HDL-C）水平低于单纯OSAHS组（P＜0.05）。高血压组TG、TC、LDL-C、MPV、HOMA-IR与MAI、AHI、ODI呈正相关（P＜0.05）,HDL-C与MAI、AHI、ODI呈负相关（P＜0.05）。高体质量指数、高HOMA-IR及TG、MPV水平升高是OSAHS患者合并高血压的危险因素（P＜0.05）。联合TG、MVP、HOMA-IR预测OSAHS患者合并高血压的曲线下面积高于以上三指标单独预测。结论：OSAHS合并高血压患者TG、MPV水平及HOMA-IR显著增高,且与MAI、AHI、ODI呈正相关,TG、MPV、HOMA-IR联合检测对OSAHS患者合并高血压的预测价值较高。

Correlation between Blood Lipid, Platelet Parameters, HOMA-IR and PSG Parameters in Patients with Obstructive Sleep Apnea Hypopnea Syndrome Complicated with Hypertension and their Predictive Value Study

ABSTRACT Objective: To investigate the correlation between blood lipid, platelet parameters, homeostasis model insulin resistance index (HOMA-IR) and polysomnography (PSG) parameters in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension and their predictive value. Methods: 163 patients with OSAHS who were admitted to Shuyang Hospital Affiliated to Xuzhou Medical University from January 2020 to November 2022 were selected, and they divided into simple OSAHS group (78 cases) and hypertension group (85 cases) according to whether they were combined with hypertension. Blood lipid, platelet parameters and HOMA-IR, PSG parameters in the two groups were measured. Pearson correlation analysis was used to analyze the correlation between blood lipid, platelet parameters, HOMA-IR and PSG parameters. Multivariate Logistic regression analysis was used to analyze the risk factors of OSAHS complicated with hypertension. The receiver operating characteristic (ROC) curve was used to analyze the value of blood lipid, platelet parameters and HOMA-IR in predicting OSAHS complicated with hypertension. Results: Triglycerides (TG), Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), mean platelet volume (MPV), HOMA-IR, micro arousal index (MAI), apnea hypopnea index (AHI) and oxygen Reduction Index (ODI) in the hypertension group were higher than those in the simple OSAHS group (P<0.05), high-density lipoprotein cholesterol (HDL-C) was lower than that in the simple OSAHS group (P<0.05). The TG, TC, LDL-C, MPV, HOMA-IR in the hypertension group were positively correlated with MAI, AHI and ODI (P<0.05), while HDL-C was negatively correlated with MAI, AHI and ODI (P<0.05). High body mass index, high HOMA-IR, TG and MPV levels were the risk factors for patients with OSAHS complicated with hypertension (P<0.05). The area under the curve of OSAHS patients with hypertension predicted by combining TG, MVP and HOMA-IR was higher than that predicted by the above three indicators alone. Conclusion: The TG, MPV levels and HOMA-IR in patients with OSAHS complicated with hypertension are significantly increased, and are positively correlated with MAI, AHI and ODI. The combined detection of TG, MPV and HOMA-IR has a higher predictive value for patients with OSAHS complicated with hypertension.