Wang Jinfeng, Fang Jinrui, Xie Yuping, Ma Wei, Hui Peilin, Su Xiaoyan, Guo Bin, Chen Xueping, Wang Xubin, Fan Jie, Zhao Yuan
Department of Sleep Medicine Center,Gansu Provincial Hospital,Lanzhou,730000,China.
Department of Day Care Center,Gansu Provincial Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 May;36(5):338-342. doi: 10.13201/j.issn.2096-7993.2022.05.003.
To analyze the related factors of secondary erythrocytosis of obstructive sleep apnea(OSA) in Gansu province. Polysomnography recording and analysis from January 2013 to January 2021, A total of 448 OSA patients of long-resident Han nationality in Gansu province. Hemoglobin(Hb) values were divided into group A(Hb 120-160 g/L) 41 cases, B(Hb 161-179 g/L) 142 cases, C(Hb 180-199 g/L) 152 cases, D(Hb 200-219 g/L) 79 cases, and E(Hb ≥220 g/L) 30 cases. General clinical data, altitude of residence, disease course, apnea hypopnea index (AHI), and Lowest oxyhemoglobin(LSpO₂) were compared among these groups. Multivariate regression and ROC curves were used to analyze the influencing factors of OSA secondary erythrocytosis. There were no significant differences in age, sex, and course of disease among groups A, B, C, D, and E (>0.05).The altitude of group E was higher than that of groups A, B, C, and D (<0.05), but there was no significant difference between groups A, B, C and D (>0.05).AHI was significantly different among groups A, B, C, D, and E (<0.05), groups C, D, and E were significantly higher than A; group D was significantly higher than B, C.LSpO₂ was significantly different among groups A, B, C, D, and E (P <0.05), groups B, C, D, and E was significantly lower than A; group D, E was significantly lower than B, C.MSpO₂ was significantly different among groups A, B, C, D, and E (<0.05), groups B, C, D, and E was significantly lower A; groups D, E was significantly lower than B , C.Multivariate regression showed that the higher the altitude, the lower the MSpO₂, the more serious the secondary hyperhemoglobinemia.Age, course of the disease, AHI, and LSpO₂ were not the influencing factors of OSA secondary hemoglobin increase.The areas under the ROC curve for MSpO₂ and altitude to predict Hb≥180 g/L were 0.694(<0.001) and 0.570(=0.009), with statistically significant differences(Z=3.205, =0.001). Altitude and MSpO₂ were independent risk factors for OSA secondary erythrocytosis; MSpO₂ predicted that Hb≥180 g/L in OSA patients was better than altitude.
分析甘肃省阻塞性睡眠呼吸暂停(OSA)继发性红细胞增多症的相关因素。对2013年1月至2021年1月期间进行多导睡眠图记录与分析,共纳入448例甘肃省常住汉族OSA患者。将血红蛋白(Hb)值分为A组(Hb 120 - 160 g/L)41例、B组(Hb 161 - 179 g/L)142例、C组(Hb 180 - 199 g/L)152例、D组(Hb 200 - 219 g/L)79例、E组(Hb≥220 g/L)30例。比较这些组间的一般临床资料、居住海拔、病程、呼吸暂停低通气指数(AHI)以及最低血氧饱和度(LSpO₂)。采用多因素回归和ROC曲线分析OSA继发性红细胞增多症的影响因素。A、B、C、D、E组间年龄、性别和病程无显著差异(>0.05)。E组海拔高于A、B、C、D组(<0.05),但A、B、C、D组间无显著差异(>0.05)。A、B、C、D、E组间AHI有显著差异(<0.05),C、D、E组显著高于A组;D组显著高于B、C组。A、B、C、D、E组间LSpO₂有显著差异(P <0.05),B、C、D、E组显著低于A组;D、E组显著低于B、C组。A、B、C、D、E组间平均血氧饱和度(MSpO₂)有显著差异(<0.05),B、C、D、E组显著低于A组;D、E组显著低于B、C组。多因素回归显示海拔越高、MSpO₂越低,继发性高血红蛋白血症越严重。年龄、病程、AHI和LSpO₂不是OSA继发性血红蛋白升高的影响因素。MSpO₂和海拔预测Hb≥180 g/L 的ROC曲线下面积分别为0.694(<0.001)和0.570(=0.009),差异有统计学意义(Z = 3.205, = 0.001)。海拔和MSpO₂是OSA继发性红细胞增多症的独立危险因素;MSpO₂对OSA患者Hb≥180 g/L的预测价值优于海拔。