Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
University of Malaya, Kuala Lumpur, Malaysia.
Sleep Breath. 2022 Jun;26(2):613-620. doi: 10.1007/s11325-021-02383-3. Epub 2021 Jun 29.
Since hypoxia increases erythropoietin production and inflammation, the complete blood count (CBC) has been proposed as an inexpensive alternative for obstructive sleep apnea (OSA) screening. The objective of this study was to determine whether or not intermittent hypoxia and OSA severity, as measured by the mean oxygen saturation (SpO) and apnea-hypopnea index (AHI), affect parameters measured by the CBC.
This retrospective study included a total of 941 surgical patients who had a pre-operative home sleep study. The pre-operative CBC was extracted from the electronic patient records. Patients were stratified according to their AHI scores, into mild (AHI ≥ 5 - < 15), moderate (AHI ≥ 15 - < 30), and severe (AHI ≥ 30) OSA groups.
There were 244 patients without OSA, 294 with mild, 223 with moderate, and 180 with severe OSA. Our analysis showed that hemoglobin (P = 0.010), hematocrit (P = 0.027), and basophils (P = 0.006) showed significant changes among the different severities of OSA. For mean SpO, there were negative associations with body mass index (r = - 0.287; P < 0.001), age (r = - 0.077; P = 0.021), hemoglobin (r = - 0.208; P < 0.001), hematocrit (r = - 0.220; P < 0.001), red blood cells (r = - 0.107; P = 0.001), mean corpuscular volume (MCV) (r = - 0.159; P < 0.001), mean corpuscular hemoglobin (r = - 0.142; P < 0.001), and basophils (r = - 0.091; P = 0.007). All analyzed parameters remained within normal clinical range. Multivariable regression identified hemoglobin, MCV, and basophils to be independent predictors of mean SpO and AHI.
Hemoglobin, MCV, and basophils were independently associated with intermittent hypoxia defined by mean SpO and AHI. Adding CBC parameters to other screening tools for OSA may have additional value due to its association with changes in mean SpO
由于缺氧会增加促红细胞生成素的产生和炎症反应，因此全血细胞计数（CBC）已被提议作为阻塞性睡眠呼吸暂停（OSA）筛查的一种廉价替代方法。本研究的目的是确定间歇性缺氧和 OSA 严重程度（以平均血氧饱和度（SpO ）和呼吸暂停低通气指数（AHI ）来衡量）是否会影响 CBC 测量的参数。
这项回顾性研究共纳入了 941 名接受术前家庭睡眠研究的手术患者。从电子患者记录中提取术前 CBC。根据 AHI 评分将患者分为轻度（AHI≥5-<15）、中度（AHI≥15-<30）和重度（AHI≥30）OSA 组。
244 例患者无 OSA，294 例为轻度 OSA，223 例为中度 OSA，180 例为重度 OSA。我们的分析表明，血红蛋白（P=0.010）、红细胞压积（P=0.027）和嗜碱性粒细胞（P=0.006）在不同严重程度的 OSA 中存在显著变化。对于平均 SpO ，与体重指数（r=-0.287；P<0.001）、年龄（r=-0.077；P=0.021）、血红蛋白（r=-0.208；P<0.001）、红细胞压积（r=-0.220；P<0.001）、红细胞计数（r=-0.107；P=0.001）、平均红细胞体积（MCV）（r=-0.159；P<0.001）、平均红细胞血红蛋白（r=-0.142；P<0.001）和嗜碱性粒细胞（r=-0.091；P=0.007）呈负相关。所有分析参数均在正常临床范围内。多变量回归分析确定血红蛋白、MCV 和嗜碱性粒细胞是平均 SpO 和 AHI 的独立预测因子。
血红蛋白、MCV 和嗜碱性粒细胞与平均 SpO 定义的间歇性缺氧独立相关，AHI。由于其与平均 SpO 变化相关，因此将 CBC 参数添加到 OSA 的其他筛查工具中可能具有额外的价值。
