新医学2025，Vol.56Issue(2)：197-205,9.DOI:10.12464/j.issn.0253-9802.2024-0396
全身炎症反应指数在阻塞性睡眠呼吸暂停合并冠心病风险预测中的临床应用
Clinical application of the systemic inflammatory response index in risk prediction of obstructive sleep apnea combined with coronary heart disease
摘要
Abstract
Objective To explore the risk factors for coronary artery disease(CAD)in patients with obstructive sleep apnea(OSA)and to establish a clinical risk prediction model based on the systemic inflammatory response index(SIRI)and to validat its effectiveness.Methods OSA patients suspected of CAD who underwent coronary angiography or coronary CT angiography at the First Affiliated Hospital of Xinjiang Medical University between April 2020 and December 2023 were enrolled.Patients were divided into CAD and non-CAD groups based on the degree of coronary artery stenosis.Variable were screened using LASSO regression and multifactor logistic regression,and a nomogram was constructed.The discrimination and calibration of the prediction model were evaluated and validated using receiver operating characteristic(ROC)curves,calibration curves,and Hosmer-Lemeshow test.The clinical effectiveness of the prediction model was assessed using decision curve analysis(DCA).Results Multivariate logistic regression results indicated the following factors for CAD in OSA patients(all P<0.05):age≥50 years(OR=1.947(95%CI 1.277-2.969)),hypertension(OR=2.462(95%CI 1.612-3.761)),diabetes(OR=2.003(95%CI 1.313-3.057)),low-density lipoprotein cholesterol(LDL-C)≥2.6 mmol/L(OR=1.793(95%CI 1.176-2.735)),apnea-hypopnea index(AHI)≥30 times/hour(OR=2.425(95%CI 1.500-3.920)),and SIRI≥0.84(OR=2.240(95%CI 1.463-3.428)).A nomogram was constructed based on these factors.The area under the ROC curve(AUC)for the prediction model was 0.721(95%CI 0.673-0.770)in the training set and 0.750(95%CI 0.678-0.820)in the validation set.Calibration curves and the Hosmer-Lemeshow test indicated good agreement between predicted and actual outcomes(training set:χ 2=7.924,P=0.542;validation set:χ 2=12.304,P=0.197).DCA demonstrated the clinical utility of the prediction model.Conclusion A risk prediction model incorporating age,hypertension,diabetes,LDL-C,AHI,and SIRI has potential clinical value for predicting CAD in OSA patients.关键词
全身炎症反应指数/临床预测模型/列线图/阻塞性睡眠呼吸暂停/冠状动脉粥样硬化性心脏病Key words
Systemic inflammatory response index/Clinical prediction model/Nomogram/Obstructive sleep apnea/Coronary heart disease引用本文复制引用
邱璇,古丽米热·艾麦提,陈玉岚,姚艳丽,王星晨,阿依古再丽·麦麦提敏..全身炎症反应指数在阻塞性睡眠呼吸暂停合并冠心病风险预测中的临床应用[J].新医学,2025,56(2):197-205,9.基金项目
国家自然科学基金(82060058) （82060058）
