半乳糖凝集素-3对心房颤动患者合并阻塞性睡眠呼吸暂停的预测价值

Predictive value of galectin-3 in patients with atrial fibrillation complicated with obstructive sleep apnea

  • 摘要:
    目的 探讨血清半乳糖凝集素-3(Gal-3)水平对心房颤动(简称房颤)患者合并阻塞性睡眠呼吸暂停(OSA)的预测价值。
    方法 选取在心内科住院的88例房颤患者,根据多导睡眠监测(PSG)结果分为房颤组呼吸暂停低通气指数(AHI) < 5次/h20例和房颤合并OSA组(AHI≥5次/h)68例,另选取同期呼吸科经PSG检查确诊OSA的19例患者设为单纯OSA组,并选取同期体检中心的80例健康体检者设为健康对照组。比较4组研究对象的临床资料、血清Gal-3水平; 采用二元Logistic回归分析探讨房颤患者合并OSA的影响因素; 绘制受试者工作特征(ROC)曲线,评价血清Gal-3水平对房颤患者合并OSA的预测价值。
    结果 房颤合并OSA组、房颤组、单纯OSA组血清Gal-3水平高于健康对照组,且房颤合并OSA组血清Gal-3水平高于房颤组、单纯OSA组,差异有统计学意义(P < 0.05)。二元Logistic回归分析显示,血清Gal-3水平为房颤患者合并OSA的独立影响因素(OR=1.547, 95%CI: 1.063~2.251, P= 0.023)。血清Gal-3水平预测房颤患者合并OSA的曲线下面积为0.779(95%CI: 1.063~2.251, P=0.023), 最佳截断值为9.49 ng/mL(敏感度82.9%, 特异度64.3%)。
    结论 血清Gal-3水平与OSA促进房颤的发生和发展相关,血清Gal-3水平升高可能对房颤患者合并OSA具有一定预测价值。

     

    Abstract:
    Objective To investigate the predictive value of level of galectin-3 (Gal-3) in patients with atrial fibrillation complicated with obstructive sleep apnea (OSA).
    Methods A total of 88 atrial fibrillation inpatients in department of cardiology were selected. According to the results of polysomnography (PSG), the patients were divided into atrial fibrillation group apnea hypopnea index (AHI) < 5 times/h, n=20and atrial fibrillation combined with OSA group (AHI≥5 times/h, n=68). In addition, 19 patients with OSA confirmed by PSG examination in respiratory department during the same period were selected as OSA alone group, and 80 healthy subjects in physical examination center during the same period were selected as healthy control group. Clinical data and serum Gal-3 levels were compared among the four groups. The influencing factors of OSA in AF patients were analyzed by binary Logistic regression. The receiver operating characteristic (ROC) curve was drawn to evaluate the value of serum Gal-3 level in predicting OSA in patients with atrial fibrillation.
    Results The levels of serum Gal-3 in the atrial fibrillation combined with OSA group, atrial fibrillation group and OSA alone group were significantly higher than those in the healthy control group, and the level of serum Gal-3 in the atrial fibrillation combined with OSA group was significantly higher than that in the atrial fibrillation group and OSA alone group (P < 0.05). Binary Logistic regression analysis showed that serum Gal-3 level was one of independent influencing factors for AF patients complicating with OSA (OR=1.547; 95%CI, 1.063 to 2.251; P= 0.023). The area under curve of serum Gal-3 for predicting in AF patients complicating with OSA was 0.779 (95%CI, 1.063 to 2.251; P= 0.023), and the optimal cut-off value was 9.49 ng/mL (with sensitivity of 82.9%, specificity of 64.3%).
    Conclusion The level of serum GAL-3 is related to the occurrence and development of AF promoted by OSA. The increased level of serum GAL-3 may have a certain predictive value for AF patients with OSA.

     

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