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中性粒细胞与淋巴细胞比值在非小细胞肺癌合并阻塞性睡眠呼吸暂停低通气综合征患者中的临床意义

Clinical significance of neutrophil to lymphocyte ratio in patients with non-small cell lung cancer complicated with obstructive sleep apnea hypopnea syndrome

    摘要
  • 摘要:
    目的 探讨中性粒细胞与淋巴细胞比值(NLR)在非小细胞肺癌合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的表达及其与睡眠呼吸暂停相关指标的关系。
    方法 选取31例首次诊断的非小细胞肺癌合并OSAHS患者纳入合并组, 另选取同期就诊的31例单纯非小细胞肺癌患者、31例健康体检者分别纳入单纯组、对照组，比较各组NLR、血小板与淋巴细胞比值(PLR)差异，分析非小细胞肺癌合并OSAHS组NLR、PLR水平与睡眠呼吸暂停相关指标的关系，并分析OSAHS对不同肺癌分期组患者NLR、PLR水平的影响。
    结果 合并组、单纯组NLR水平分别为(4.95±3.36)、(3.61±1.48), 均高于对照组的(1.87±0.48), 差异有统计学意义(P＜0.01);合并组NLR水平高于单纯组，差异有统计学意义(P＜0.05)。合并组、单纯组PLR水平均高于对照组，差异有统计学意义(P＜0.05或P＜0.01);合并组PLR水平与单纯组比较，差异无统计学意义(P＞0.05)。偏相关分析结果显示，校正年龄、体质量指数(BMI)后, NLR与非小细胞肺癌合并OSAHS患者睡眠呼吸暂停低通气指数(AHI)呈正相关(r=0.567, P=0.002), 与最低动脉血氧饱和度(SaO2)呈负相关(r=-0.340, P=0.048)。Ⅰ~Ⅲ期肺癌组中，合并OSAHS患者的NLR、PLR水平高于无OSAHS患者，差异有统计学意义(P＜0.05);Ⅳ期肺癌组中，合并OSAHS患者的NLR、PLR水平亦高于无OSAHS患者，但差异无统计学意义(P＞0.05)。
    结论 非小细胞肺癌合并OSAHS患者的NLR水平相较单纯非小细胞肺癌患者和健康者显著升高，且其NLR水平与AHI、最低SaO2具有相关性。

     

    Abstract:
    Objective To investigate the expression of neutrophil to lymphocyte ratio (NLR) and its relationship with obstructive sleep apnea hypoventilation syndrome (OSAHS) in non-small cell lung cancer patients with OSAHS.
    Methods Thirty-one initially diagnosed as non-small-cell lung cancer patients combined with OSAHS were selected as combination group, and 31 patients with simple non-small-cell lung cancer and 31 healthy people were selected as simple group and control group, respectively. The differences in NLR, platelet to lymphocyte ratio (PLR) among groups were compared. Correlations of NLR and PLR with indicators related to sleep apnea in the combined group, and effects of OSAHS on NLR and PLR levels of patients with different lung cancer stages were analyzed.
    Results NLR levels in the combined group and the simple group were (4.95±3.36) and (3.61±1.48), respectively, which were higher than (1.87±0.48) in the control group (P < 0.01). The level of NLR in the combined group was higher than that in the simple group (P < 0.05). The PLR levels of the combined group and the simple group were higher than those of the control group (P < 0.05 or P < 0.01). There was no significant difference in PLR level between the combined group and the simple group (P > 0.05). A partial correlation analysis showed that after adjusting for age and BMI, NLR had a positive correlation with sleep apnea hypopnea index (AHI) (r=0.567, P=0.002)and a negative correlation with minimum arterial oxygen saturation (SaO2) in non-small cell lung cancer combined with OSAHS patients(r=-0.340, P=0.048). The levels of NLR and PLR in patients complicated with OSAHS in stage Ⅰ to Ⅲ lung cancer group were higher than those in patients without OSAHS (P < 0.05). The levels of NLR and PLR in patients complicated with OSAHS were also higher than those in patients without OSAHS in stage Ⅳ lung cancer group, but the differences were not statistically significant (P > 0.05).
    Conclusion NLR levels are significantly increased in patients with non-small cell lung cancer combined with OSAHS compared with the controls and patients with simple non-small cell lung cancer, and there are correlations of NLR level with AHI and the minimum SaO2.

     

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