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

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

  • 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。

     

    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.

     

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