Page 126 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第43卷第5期
·708 · Journal of Nanjing Medical University（Natural Sciences） 2023年5月

·临床研究·

PLR在OSAHS患者新发脑梗死中的临床应用价值

章伟云 ，丁 宁 ，孙云宇 ，陈伟凯 ，王发胜 ，杨明刚 ，陈 聪 ，唐金荣 1*
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南京医科大学第一附属医院神经内科，呼吸科，输血科，江苏 南京 210029；盱眙县人民医院神经内科，江苏 淮安
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223001
［摘 要］ 目的：探讨血小板⁃淋巴细胞比值（platelet lymphocyte ratio，PLR）在阻塞性睡眠呼吸暂停低通气综合征（obstructive
sleep apnea hypopnea syndrome，OSAHS）患者新发脑梗死中的变化，并分析 PLR 对 OSAHS 患者新发脑梗死的临床预测价值。
方法：对155例OSAHS患者的病历资料进行回顾性分析；根据有无新发脑梗死分为单纯OSAHS组（Ａ组93例）和OSAHS合并
脑梗死组（Ｂ组62例），根据呼吸暂停低通气指数（apnea hypopnea index，AHI）将Ｂ组患者分为轻、中、重3级；收集两组的临床
数据并采用 SPSS 25.0 软件分析两者的相关性以及 PLR 预测 OSAHS 患者新发脑梗死的效能。结果：①两组之间淋巴细胞计
数、血小板计数、中性粒细胞计数、中性粒细胞⁃淋巴细胞比值（neutrophil lymphocyte ratio，NLR）、血氧饱和度<90%时间占监测
总时间的百分比（TS90%）、PLR、AHI之间有显著差异（P＜0.05）；②Ｂ组患者PLR与AHI呈正相关（P＜0.001）；③Logistic回归
分析示PLR是OSAHS患者新发脑梗死的独立危险因素（P＜0.001）；④ROC 曲线分析显示血清PLR预测OSAHS患者新发脑梗
死的最佳截断值为130.79，曲线下面积为0.888（95% CI：0.832~0.945）。结论：OSAHS合并脑梗死患者血清PLR值会随着AHI
值的增加有递增趋势；而且PLR可能是OSAHS新发脑梗死的独立预测因子。
［关键词］ 急性缺血性脑梗死；阻塞性睡眠呼吸暂停低通气综合征；多导睡眠图；呼吸暂停低通气指数；血小板⁃淋巴细胞比值
［中图分类号］ R743.32 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）05⁃708⁃06
doi：10.7655/NYDXBNS20230517

Clinical value of platelet⁃lymphocyte ratio for acute ischemic stroke in OSAHS patients

ZHANG Weiyun ，DING Ning ，SUN Yunyu ，CHEN Weikai ，WANG Fasheng ，YANG Minggang ，CHEN Cong ，
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TANG Jinrong 1*
Department of Neurology，Department of Pneumology，Department of Hematology，the First Affiliated，Hospital of
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Nanjing Medical University，Nanjing 210029；Department of Neurology，Xuyi People’s Hospital，Huaian 223001，
China
［Abstract］ Objective：To investigate the changes of platelet⁃lymphocyte ratio（PLR）in obstructive sleep apnea hypopnea syndrome
（OSAHS）patients with acute ischemic stroke and the clinical value of PLR. Methods：The case data of 155 patients with OSAHS were
retrospectively analyzed. According to the presence or absence of acute ischemic stroke，patients were divided into simple OSAHS
group（group A，n=93）and OSAHS combined with acute ischemic stroke group（group B，n=62）. According to apnea hypopnea index
（AHI），patients in group B were divided into three grades：mild，medium and severe. Clinical data of the two groups were collected and
SPSS 25.0 software was used to analyze the correlation between the two groups and the efficacy of PLR in predicting acute ischemic
stroke in OSAHS patients. Results：①There were significant differences in LYM，PLT，NEUT，neutrophil lymphocyte ratio（NLR），
PLR，TS90% and AHI between the two groups（P < 0.05）. ② PLR was positively correlated with AHI in group B（P=0.000）. ③
Logistics analysis showed that PLR was an independent risk factor for acute ischemic stroke in OSAHS patients（P=0.000）. ④ROC
curve analysis showed that the best cut⁃off value of serum PLR for predicting acute ischemic stroke in OSAHS patients was 130.79，and
the area under the curve was 0.888（95%CI：0.832⁃0.945）. Conclusions：High serum PLR is positively correlated with AHI in OSAHS
patients with acute ischemic stroke，and PLR may be an independent predictor of acute ischemic stroke in OSAHS.
［Key words］ acute ischemic stroke；obstructive sleep apnea hypopnea syndrome；polysomnography；apnea hypopnea index；platelet
lymphocyte ratio
［J Nanjing Med Univ，2023，43（05）：708⁃713］
［基金项目］ 国家自然科学基金面上项目（82070093）；南京市政府重大项目（2019060002）
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通信作者（Corresponding author），E⁃mail：chencong2006nyd@163.com；tangjr2622@163.com