NLR与阻塞性睡眠呼吸暂停综合征的相关性研究

Study on the Correlation between NLR and Obstructive Sleep Apnea Syndrome

摘要: 目的：探讨中性粒细胞与淋巴细胞比值(Neutrophil-to-Lymphocyte Ratio, NLR)与阻塞性睡眠呼吸暂停综合征(Obstructive Sleep Apnea Syndrome, OSAS)严重程度之间的关系。方法：回顾性分析2021年9月~2022年9月于新疆医科大学第五附属医院住院期间确诊为OSAS的120名患者相关实验室资料，根据呼吸暂停低通气指数(Apnea-Hypopnea Index, AHI)分为轻、中、重三组，并收集同期因单纯鼾症于本院就诊的80名病人作为对照组，应用多导睡眠监测仪(Polysomnography, PSG)记录患者相关睡眠参数，并检测外周血白细胞细胞(WBC)、中性粒细胞计数、淋巴细胞计数、NLR、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、BMI及夜间基础心率等指标。比较4组上述各指标之间有无差异，行相关性分析，探讨反映OSAS患者严重程度的危险因素，行Pearson检验对NLR与AHI进行相关性分析，以ROC曲线评价NLR指标对OSAS患者的临床应用价值。结果：1) 各组间BMI、NLR、WBC、Hcy、AHI、最低SpO2、平均SpO2、最长呼吸暂停时间之间存在统计学差异(P < 0.05)；2) NLR与AHI之间存在显著线性相关性(P < 0.05)，进一步发现NLR与AHI均呈现正相关(r = 0.321, P < 0.001)；3) NLR预测OSAS的ROC曲线下面积为0.837，最佳截断值为2.18，灵敏度达60.80%、特异度96.30%；4) NLR会随着OSAS疾病严重度增加而升高，差异均有统计学意义(P < 0.05)。结论：NLR与OSAS严重程度之间存在显著相关性，有一定的临床价值。

Abstract: Objective: to investigate the ratio of neutrophils and lymphocytes (NLR) and obstructive sleep ap-nea syndrome (OSAS) the relationship between the severity. How: The relevant laboratory data of 120 patients diagnosed with OSAS during their hospitalization in the Fifth Affiliated Hospital of Xin-jiang Medical University from September 2021 to September 2022 were retrospectively analyzed, and they were divided into three groups according to Apnea-Hypopnea Index (AHI): mild, moderate and severe. A total of 80 patients admitted to our hospital due to simple snoring during the same period were collected as the control group. Polysomnography (PSG) was used to record the sleep parameters of the patients. Peripheral blood white blood cell (WBC), neutrophil count, lymphocyte count, NLR, total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), BMI and nightly basal heart rate were detected. Correlation analysis was performed to explore the risk factors reflecting the severity of OSAS patients. Pearson test was performed to analyze the correla-tion between NLR and AHI, and ROC curve was used to evaluate the clinical application value of NLR indicators in OSAS patients. Results: 1) There were significant differences in BMI, NLR, WBC, Hcy, AHI, minimum SpO2, average SpO2 and longest apnea time among all groups (P < 0.05). 2) There was a significant linear correlation between NLR and AHI (P < 0.05), and it was further found that both NLR and AHI were positively correlated (r = 0.321, P< 0.001). 3) NLR predicted that the area under ROC curve of OSAS was 0.837, the best cutoff value was 2.18, the sensitivity was 60.80%, and the specificity was 96.30%. 4) NLR increased with the increase of OSAS disease severity, and the differences were statistically significant (P < 0.05). Conclusion: There is a significant correlation between NLR and the severity of OSAS, which has certain clinical value.