天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (12): 1324-1327.doi: 10.11958/20211181

• 临床研究 • 上一篇    下一篇

血清PTX3联合CHA2DS2-VASc评分对OSAHS合并房颤患者发生脑梗死的预测价值

冯慧琼 1，董峰 2，孟祥君 1，牛文亮 1，席富强 1，王伟 1△   

  1. 1内蒙古科技大学包头医学院第一附属医院神经内一科（邮编014010）；2内蒙古包头包钢第三职工医院骨科
  • 收稿日期:2021-05-19 修回日期:2021-07-15 出版日期:2021-12-15 发布日期:2021-12-27
  • 通讯作者: △通信作者 E-mail：wangwei_200636@sina.com E-mail:wangwei_200636@sina.com
  • 作者简介:冯 慧 琼（1985），女 ，硕 士 ，副 主 任 医 师 ，主 要 从 事 脑 血 管 疾 病 、睡 眠 障 碍 及 认 知 功 能 障 碍 方 面 研 究 。 E-mail： fenhuiqiong5623015@163.com

Predictive value of serum pentraxin-3 combined with CHA2DS2-VASc score for cerebral infarction in patients with obstructive sleep apnea hypopnea syndrome and atrial fibrillation

FENG Hui-qiong1, DONG Feng2, MENG Xiang-jun1, NIU Wen-liang1, XI Fu-qiang1, WANG Wei1△   

  1. 1 The First Department of Neurology, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014010, China; 2 Department of Orthopedics, Baogang Third Staff Hospital, Baotou, Inner Mongolia △Corresponding Author E-mail: wangwei_200636@sina.com
  • Received:2021-05-19 Revised:2021-07-15 Published:2021-12-15 Online:2021-12-27
  • Contact: △Corresponding Author E-mail: wangwei_200636@sina.com E-mail:wangwei_200636@sina.com

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摘要： 目的 探讨血清正五聚蛋白-3（PTX3）联合CHA2DS2-VASc 评分对阻塞性睡眠呼吸暂停低通气综合征 （OSAHS）合并房颤患者发生脑梗死的预测价值。方法 选取OSAHS合并房颤患者198例，根据随访期间是否发生 脑梗死分为脑梗死组（36例）和无脑梗死组（162例）。比较脑梗死组和无脑梗死组的各项指标，分析OSAHS合并房 颤患者血清PTX3水平与其他指标的相关性，Logistic回归分析OSAHS合并房颤患者发生脑梗死的危险因素，受试者 工作特征曲线分析PTX3联合CHA2DS2-VASc评分对OSAHS合并房颤患者发生脑梗死的预测价值。结果 脑梗死 组的收缩压、低密度脂蛋白胆固醇（LDL-C）、左心房内径（LAD）、呼吸暂停低通气指数（AHI）、CHA2DS2-VASc评分 以及PTX3水平均高于无脑梗死组（P＜0.05）；OSAHS合并房颤患者血清PTX3水平与LDL-C、LAD、AHI、CHA2DS2- VASc评分均呈正相关（P＜0.05）；多因素Logistic回归分析显示，较高水平的AHI、CHA2DS2-VASc评分以及PTX3均 为OSAHS合并房颤患者发生脑梗死的危险因素（P＜0.05）；PTX3与CHA2DS2-VASc评分预测OSAHS合并房颤患者 发生脑梗死的曲线下面积分别为0.785（0.695~0.875）和0.794（0.698~0.890），两者联用分析后敏感度和约登指数均有 了明显的提升。结论 血清PTX3联合CHA2DS2-VASc评分对OSAHS合并房颤患者发生脑梗死的预测价值较高。

关键词: 睡眠呼吸暂停, 阻塞性, 心房颤动, 脑梗死, 正五聚蛋白-3, CHA2DS2-VASc评分

Abstract: Objective To investigate the prediction value of serum pentraxin 3 (PTX3) combined with CHA2DS2- VASc score for cerebral infarction in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and atrial fibrillation. Methods A total of 198 OSAHS patients with atrial fibrillation were selected. According to whether cerebral infarction occurred during the follow-up period, patients were divided into the cerebral infarction group (36 cases) and the non-cerebral infarction group (162 cases). The indexes were compared between the cerebral infarction group and the noncerebral infarction group. The correlation between serum PTX3 and other indexes in OSAHS patients with atrial fibrillation were analyzed. The risk factors of cerebral infarction in OSAHS patients with atrial fibrillation were analyzed. The predictive value of PTX3 combined with CHA2DS2-VASc score for cerebral infarction in patients with OSAHS complicated with atrial fibrillation was analyzed. Results The systolic blood pressure, low density lipoprotein cholesterol (LDL-C), left atrial diameter (LAD), apnea hypopnea index (AHI), CHA2DS2- VASc score and PTX3 were significantly higher in the cerebral infarction group than those in the non-cerebral infarction (P＜0.05). Serum PTX3 levels were positively correlated with LDL-C, LAD, AHI and CHA2DS2-VASc scores in patients with OSAHS and atrial fibrillation (P＜0.05). Multivariate Logistic regression analysis showed that the increased LAD, AHI, CHA2DS2-VASc score and PTX3 were risk factors for cerebral infarction in patients with OSAHS and atrial fibrillation (P＜0.05). The areas under the curve of PTX3 and CHA2DS2-VASc scores in predicting cerebral infarction in patients with OSAHS complicated with atrial fibrillation were 0.785 (0.695-0.875) and 0.794 (0.698-0.890), respectively. The combined analysis of PTX3 and CHA2DS2-VASc scores showed that the sensitivity and Youden index were significantly improved. Conclusion Serum PTX3 combined with CHA2DS2-VASc score has a higher predictive value for cerebral infarction in patients with OSAHS and atrial fibrillation.

Key words: sleep apnea, obstructive, atrial fibrillation, brain infarction, pentraxin-3, CHA2DS2-VASc score

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