Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China.
Sleep Breath. 2024 Jun;28(3):1329-1335. doi: 10.1007/s11325-024-03013-4. Epub 2024 Feb 28.
The aim of this study is to investigate the role of the neutrophil to lymphocyte ratio (NLR) in patients diagnosed with the chronic obstructive pulmonary disease-obstructive sleep apnea (COPD-OSA) overlap syndrome and comorbid pulmonary hypertension (PH).
We enrolled a consecutive of stable COPD patients and conducted spirometry measurements, nocturnal polysomnography (PSG), and echocardiography for all participants. Clinical laboratory data were collected.
A total of 178 patients with stable COPD were enrolled among whom 33.14% (59/178) were diagnosed with OSA. Of the patients with overlap syndrome, 35.59% (21/59) showed comorbid PH, compared to 34.45% (41/119) in COPD patients without OSA. There was no significant difference in the occurrence of PH between COPD with and without OSA. NLR was significantly higher in patients with overlap syndrome compared to those with either disease alone. The difference in NLR between COPD-OSA patients with and without PH was not significant. Correlation analysis revealed that NLR was associated with age, total sleep time spent with oxygen saturation below 90% (T90), CRP, pulmonary artery systolic pressure (PASP), and minimum peripheral capillary oxygen saturation (SpO2min) in all COPD patients. NLR was identified as an independent factor contributing to OSA in COPD. The median cut-off value for detecting OSA in stable COPD was 2.49. However, NLR was not found to be a predictor for PH in COPD-OSA overlap syndrome.
NLR can serve as a predictive marker for comorbid OSA in patients with COPD. NLR is expected to increase its clinical application as a convenient and cost-effective biomarker for COPD-OSA overlap syndrome.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）在诊断慢性阻塞性肺疾病-阻塞性睡眠呼吸暂停（COPD-OSA）重叠综合征合并肺动脉高压（PH）患者中的作用。
我们连续纳入了稳定期 COPD 患者，并对所有患者进行了肺功能检查、夜间多导睡眠图（PSG）和超声心动图检查。收集了临床实验室数据。
共纳入了 178 例稳定期 COPD 患者，其中 33.14%（59/178）被诊断为 OSA。在重叠综合征患者中，35.59%（21/59）合并 PH，而在无 OSA 的 COPD 患者中为 34.45%（41/119）。COPD 合并和不合并 OSA 患者中 PH 的发生率无显著差异。重叠综合征患者的 NLR 明显高于单独患有 COPD 或 OSA 的患者。COPD-OSA 患者中 PH 与无 PH 患者的 NLR 差异无统计学意义。相关性分析显示，在所有 COPD 患者中，NLR 与年龄、总睡眠时间氧饱和度低于 90%（T90）、C 反应蛋白、肺动脉收缩压（PASP）和最小外周毛细血管血氧饱和度（SpO2min）有关。NLR 是 COPD 患者发生 OSA 的独立因素。稳定 COPD 患者中检测 OSA 的 NLR 中位数截断值为 2.49。然而，NLR 并不是 COPD-OSA 重叠综合征中 PH 的预测因子。
NLR 可作为 COPD 患者合并 OSA 的预测标志物。NLR 有望作为一种方便、经济有效的 COPD-OSA 重叠综合征的生物标志物，增加其临床应用。
