夜间脉搏血氧饱和度对阻塞性睡眠呼吸暂停低通气综合征伴2型糖尿病患者的预测价值

曹思佩; 王洪眉; 吴峰

doi:10.7619/jcmp.20214030

夜间脉搏血氧饱和度对阻塞性睡眠呼吸暂停低通气综合征伴2型糖尿病患者的预测价值

1.
扬州大学医学院, 江苏扬州, 225009
2.
扬州大学附属医院呼吸与危重症医学科, 江苏扬州, 225003

基金项目:

江苏省科学技术厅计划项目 BE2016710

详细信息

通讯作者:
吴峰, E-mail: yzwufeng888@163.com

中图分类号: R587.1;R56
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出版历程
- 收稿日期: 2021-10-12
- 网络出版日期: 2022-03-22
- 发布日期: 2022-03-14

Value of nocturnal pulse oxygen saturation in predicting patients with obstructive sleep apnea hypopnea syndrome complicating with type 2 diabetes

1.
School of Medicine of Yangzhou University, Yangzhou, Jiangsu, 225009
2.
Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, 225003

摘要

摘要:
目的探讨夜间脉搏血氧饱和度(SpO₂)水平对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴2型糖尿病患者的预测价值。
方法回顾性分析153例OSAHS患者的临床资料, 根据是否患有2型糖尿病分为OSAHS伴2型糖尿病组77例和单纯OSAHS组76例。比较2组人口统计学资料、病史资料和SpO₂水平，并分析夜间SpO₂对OSAHS患者伴2型糖尿病的预测效能。
结果与单纯OSAHS组比较, OSAHS伴2型糖尿病组患者年龄较大，体质量指数(BMI)、呼吸暂停低通气指数(AHI)和氧减指数(ODI)较高，高脂血症患病率和有糖尿病家族史者占比较高，平均脉搏血氧饱和度(MSpO₂)和最低脉搏血氧饱和度(LSpO₂)水平较低，差异有统计学意义(P＜0.05)。二元Logistic回归分析发现，年龄小(OR=0.247, 95%CI为0.110~0.553, P=0.001)、BMI低(OR=0.366, 95%CI为0.152~0.881, P=0.025)是OSAHS患者伴2型糖尿病的保护因素，高脂血症(OR=2.337, 95%CI为1.068~5.113, P=0.034)、LSpO₂降低(OR=3.511, 95%CI为1.132~10.891, P=0.030)是OSAHS患者伴2型糖尿病的危险因素。LSpO₂预测OSAHS患者伴2型糖尿病的最佳截断值为76.50%(敏感度54.5%, 特异度75.0%)。
结论夜间LSpO₂与OSAHS患者2型糖尿病的发生有关, LSpO₂水平降低可能对OSAHS患者伴发2型糖尿病具有一定预测价值。
- 阻塞性睡眠呼吸暂停低通气综合征 /
- 2型糖尿病 /
- 血氧饱和度 /
- 预测价值
Abstract:
Objective To investigate the predictive value of nocturnal pulse oxygen saturation(SpO₂) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) complicating with type 2 diabetes.
Methods The clinical data of 153 patients with OSAHS were retrospectively analyzed, and they were divided into single OSAHS group (76 cases) and OSAHS with type 2 diabetes group (77 cases) according to whether they had type 2 diabetes or not. The demographic data, the medical history data and SpO₂ level between the two groups were compared, and the predictive efficacy of nocturnal SpO₂ for OSAHS patients with type 2diabetes was analyzed.
Results Compared with the single OSAHS group, the age of the OSAHS with type 2 diabetes group was older, body mass index (BMI), apnea hypopnea index (AHI) and oxygen deoxygenation index (ODI) were higher, prevalence of hyperlipidemia and proportion of family history of diabetes were higher, the mean oxygen saturation (MSpO₂) and lowest oxygen saturation (LSpO₂) levels were lower (P < 0.05). Logistic regression analysis showed that younger age(OR=0.247, 95%CI, 0.110 to 0.553, P=0.001) and lower BMI(OR=0.366, 95%CI, 0.152 to 0.881, P=0.025) were protective factors forOSAHS patients complicating with type 2 diabetes, while hyperlipidemia (OR=2.337, 95%CI, 1.068 to 5.113, P=0.034)and decreased LSpO₂(OR=3.511, 95%CI, 1.132 to 10.891, P=0.030) were risk factors for OSAHS patients with type 2 diabetes. The optimal cut-off value of LSpO₂ in predicting OSAHS patients with type 2 diabetes mellitus was 76.50% (with sensitivity of 54.5%, specificity of 75.0%).
Conclusion LSpO₂ is associated with the occurrence of type 2 diabetes in patients with OSAHS, and the reduced LSpO₂ level may have a certain predictive value for patients with OSAHS complicating with type 2 diabetes.
- obstructive sleep apnea hypopnea syndrome /
- type 2 diabetes /
- blood oxygen saturation /
- predictive value

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图 1 LSpO₂预测OSAHS患者伴2型糖尿病的ROC曲线

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表 1 2组患者一般资料与睡眠监测指标水平比较(x±s) [n(%)]

指标	OSAHS伴2型糖尿病组(n=77)	单纯OSAHS组(n=76)	t/χ²	P
年龄/岁	59.19±12.17	54.42±13.14	-2.332	0.021
性别男	51(66.23)	56(73.68)	1.010	0.315
女	26(33.77)	20(26.32)
BMI/(kg/m²)	27.65±4.20	25.52±2.85	-3.680	＜0.001
吸烟史	26(33.77)	22(28.95)	0.413	0.521
饮酒史	24(31.17)	22(28.95)	0.09	0.764
高血压病	60(77.92)	55(72.37)	0.632	0.427
高脂血症	46(59.74)	28(36.84)	8.03	0.005
动脉粥样硬化性心血管疾病	31(40.26)	36(47.37)	0.785	0.376
糖尿病家族史	19(24.68)	9(11.84)	4.213	0.040
AHI/(次/h)	31.98±22.22	25.45±17.87	-2.004	0.047
ODI/(次/h)	29.28±23.49	22.46±16.92	-2.063	0.041
MSpO₂/%	92.64±3.24	94.50±3.37	3.482	0.001
LSpO₂/%	70.61±12.05	78.04±8.97	4.327	＜0.001
OSAHS: 阻塞性睡眠呼吸暂停低通气综合征; BMI: 体质量指数; AHI: 呼吸暂停低通气指数; ODI: 氧减指数; MSpO₂: 平均脉搏血氧饱和度; LSpO₂: 最低脉搏血氧饱和度。

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表 2 OSAHS患者伴2型糖尿病影响因素的二元Logistic回归分析

因素	B	SE	Walds	P	OR	95%CI
年龄/岁	-1.399	0.412	11.554	0.001	0.247	0.110~0.553
BMI/(kg/m²)	-1.004	0.448	5.033	0.025	0.366	0.152~0.881
高脂血症	0.849	0.399	4.517	0.034	2.337	1.068~5.113
糖尿病家族史	0.979	0.512	3.654	0.056	2.661	0.976~7.258
AHI/(次/h)	0.259	0.667	0.151	0.697	1.296	0.351~4.787
ODI/(次/h)	0.469	0.732	0.41	0.522	1.598	0.380~6.712
MSpO₂/%	0.762	0.457	2.772	0.096	2.142	0.874~5.251
LSpO₂/%	1.256	0.578	4.728	0.030	3.511	1.132~10.891
OSAHS: 阻塞性睡眠呼吸暂停低通气综合征; AHI: 呼吸暂停低通气指数; ODI: 氧减指数; BMI: 体质量指数; MSpO₂: 平均脉搏血氧饱和度; LSpO₂: 最低脉搏血氧饱和度。

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夜间脉搏血氧饱和度对阻塞性睡眠呼吸暂停低通气综合征伴2型糖尿病患者的预测价值

通讯作者: 吴峰, E-mail: yzwufeng888@163.com

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Value of nocturnal pulse oxygen saturation in predicting patients with obstructive sleep apnea hypopnea syndrome complicating with type 2 diabetes

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通讯作者:
吴峰, E-mail: yzwufeng888@163.com