阻塞性睡眠呼吸暂停低通气综合征病人颈动脉粥样硬化危险因素的列线图模型开发与验证

    Development and validation of a column-line graphical model of carotid atherosclerosis risk factors in patients with obstructive sleep apnoea syndrome

    • 摘要:
      目的 分析影响阻塞性睡眠呼吸暂停综合征低通气(OSAHS)病人发生颈动脉粥样硬化(CAS)的危险因素,基于此开发出相应的列线图模型并加以验证。
      方法 选取门诊收治的疑似OSAHS病人,经过诊断筛查根据是否存在CAS分为CAS组和非CAS组,比较2组病人的临床相关资料,采用多因素logistic回归分析有效影响因素并绘制列线图模型图并检验列线图的有效价值。
      结果 2组在体质量指数(BMI)、舒张压、收缩压、高血压史、高脂血症史、饮酒史、CRP以及OSAHS严重程度差异有统计学意义(P < 0.05);多因素logistic回归分析显示:BMI≥25 kg/m2、高血压史、高脂血症史、C反应蛋白≥12.55 mg/L、OSAHS严重程度是OSAHS病人发生CAS的影响因素(P < 0.05);AUC为0.890(95%CI:0.810~0.971)。最大约登指数为0.608,敏感性为0.859,特异性为0.879。
      结论 BMI≥25 kg/m2、高血压史、高脂血症史、CRP≥12.55 mg/L、OSAHS严重程度与OSAHS病人发生CAS密切相关,基于此构建的列线图模型可作为风险筛查的工具之一。

       

      Abstract:
      Objective To analyze the risk factors affecting the occurrence of carotid atherosclerosis (CAS) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and to develop and validate the corresponding nomogram model.
      Methods Patients with suspected OSAHS admitted to the outpatient department of the hospital were selected, and divided into a CAS group and a non-CAS group based on the presence or absence of CAS through diagnostic screening.The clinical data of patients in the two groups were compared.Multiple logistic regression analysis was used to identify effective influencing factors, a nomogram model was drawn, and the efficacy of the model was validated.
      Results There were statistically significant differences in body mass index (BMI), diastolic blood pressure, systolic blood pressure, history of hypertension, history of hyperlipidemia, history of alcohol consumption, C-reactive protein, and severity of OSAHS between the two groups (P < 0.05).Multivariate logistic regression analysis showed that BMI≥25 kg/m2, history of hypertension, history of hyperlipidemia, C-reactive protein≥12.55 mg/L, and severity of OSAHS were the influencing factors for the occurrence of CAS in OSAHS patients (P < 0.05).The area under the ROC curve was 0.890 (95%CI: 0.810-0.971), the maximum Youden index was 0.608, sensitivity was 0.859, and specificity was 0.879.
      Conclusions BMI≥25 kg/m2, history of hypertension, history of hyperlipidemia, C-reactive protein≥12.55 mg/L, and severity of OSAHS are closely related to the occurrence of CAS in OSAHS patients.The nomogram model constructed based on this can be used as one of the risk screening tools.

       

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