多导睡眠图在阻塞性睡眠呼吸暂停低通气综合征合并高血压及继发性动脉粥样硬化患者中的诊断价值
The diagnostic value of polysomnography in obstructive sleep apnea-hypopnea syndrome patients with hypertension and secondary atherosclerosis.
作者信息
Chen Guangxi, Zhang Min, Zhou Jing, Wang Tao, Zhu Mei, Liu Zhiqiang
机构信息
Department of Sleep Medicine, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang NO. 1 People's Hospital Jiujiang 332000, Jiangxi, China.
出版信息
Am J Transl Res. 2025 May 15;17(5):3928-3938. doi: 10.62347/CYRN3387. eCollection 2025.
OBJECTIVE
To investigate the utility of polysomnography (PSG) in diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with hypertension who develop secondary atherosclerosis, and to identify effective indicators for predicting arterial sclerosis.
METHODS
140 OSAHS patients with hypertension diagnosed in Jiujiang NO. 1 People's Hospital from January 2021 to December 2023 were enrolled in this retrospective study and divided into two groups based on the presence of arteriosclerosis: the control group (without arteriosclerosis) and the research group (with arteriosclerosis). Univariate analysis, Pearson correlation analysis, and multivariate logistic regression analysis were used to identify independent factors affecting arteriosclerosis. The diagnostic performance of these factors were evaluated using a receiver operating characteristic (ROC) curve analysis.
RESULTS
Compared with the control group, the research group showed significantly higher levels of fasting blood glucose (FBG), triglyceride (TG), low-density lipoprotein (LDL), apnea-hypopnea index (AHI), systolic blood pressure (SBP), and intima-media thickness (IMT), and a significantly lower level of minSpO (<0.05). In patients with OSAHS and hypertension, FBG, TG, LDL, AHI, SBP, and IMT were positively correlated with secondary atherosclerotic diseases (r=0.273, 0.249, 0.190, 0.294, 0.198, 0.506, all <0.05), while minSpO was negatively correlated with secondary atherosclerotic diseases (r=-0.199, <0.05). FBG, TG, LDL, AHI, minSpO, SBP, and IMT were identified as independent risk factors for the development of atherosclerosis in patients with OSAHS and hypertension (<0.05), with the area under the receiver operator characteristic curves of 0.668, 0.647, 0.636, 0.690, 0.636, 0.608, 0.805, and 0.922 for single and combined tests, respectively (<0.05).
CONCLUSION
The AHI and minSpO from PSG can predict arteriosclerosis. Combining them with FBG, TG, LDL, SBP, and IMT improves the accuracy of risk assessment.
目的
探讨多导睡眠图（PSG）在诊断合并继发性动脉粥样硬化的高血压阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中的应用，并确定预测动脉硬化的有效指标。
方法
本回顾性研究纳入了2021年1月至2023年12月在九江市第一人民医院诊断的140例高血压OSAHS患者，根据是否存在动脉硬化分为两组：对照组（无动脉硬化）和研究组（有动脉硬化）。采用单因素分析、Pearson相关分析和多因素逻辑回归分析来确定影响动脉硬化的独立因素。使用受试者工作特征（ROC）曲线分析评估这些因素的诊断性能。
结果
与对照组相比，研究组的空腹血糖（FBG）、甘油三酯（TG）、低密度脂蛋白（LDL）、呼吸暂停低通气指数（AHI）、收缩压（SBP）和内膜中层厚度（IMT）水平显著更高，而最低血氧饱和度（minSpO）水平显著更低（<0.05）。在OSAHS合并高血压患者中，FBG、TG、LDL、AHI、SBP和IMT与继发性动脉粥样硬化疾病呈正相关（r = 0.273、0.249、0.190、0.294、0.198、0.506，均<0.05），而minSpO与继发性动脉粥样硬化疾病呈负相关（r = -0.199，<0.05）。FBG、TG、LDL、AHI、minSpO、SBP和IMT被确定为OSAHS合并高血压患者发生动脉硬化的独立危险因素（<0.05），单因素和联合检测的受试者工作特征曲线下面积分别为0.668、0.647、0.636、0.690、0.636、0.608、0.805和0.922（<0.05）。
结论
PSG的AHI和minSpO可预测动脉硬化。将它们与FBG、TG、LDL、SBP和IMT相结合可提高风险评估的准确性。
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