急性缺血性卒中患者中与中重度阻塞性睡眠呼吸暂停相关的临床指标及中性粒细胞与淋巴细胞比值：一项单中心回顾性研究
Clinical Indicators and Neutrophil-to-Lymphocyte Ratio Associated with Moderate-to-Severe Obstructive Sleep Apnea in Patients with Acute Ischemic Stroke: A Single-Center Retrospective Study.
文献信息
| PMID | 42807518 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yan Liu |
| 作者单位 | Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, People's Republic of China. |
| 期刊 | Nature and science of sleep |
| SCI 分区 | Q2 |
| IF | 4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 探讨易获取的临床指标及中性粒细胞与淋巴细胞比值（NLR）与急性缺血性卒中患者中重度阻塞性睡眠呼吸暂停（OSA）的相关性，并探索BMI、NLR以及BMI、打鼾和NLR联合的判别效能。
方法： 这项单中心回顾性研究纳入220例急性缺血性卒中患者，这些患者在2024年10月至2026年4月住院期间完成了整夜多导睡眠监测。中重度OSA定义为呼吸暂停低通气指数≥15次/小时。比较组间临床特征、实验室指标和多导睡眠监测参数。采用多变量logistic回归评估与中重度OSA相关的因素，并通过受试者工作特征分析评估判别效能。采用Spearman相关和NLR三分位分析探讨NLR与睡眠呼吸障碍及夜间低氧的关系。
结果： 220例患者中有109例（49.5%）存在中重度OSA。在对预设临床协变量进行多变量调整后，较高的BMI（aOR 1.204，95% CI 1.088-1.332）、打鼾（aOR 2.910，95% CI 1.485-5.705）和较高的NLR（aOR 2.291，95% CI 1.449-3.622）仍与中重度OSA相关。改良Poisson敏感性分析显示BMI、打鼾和NLR的相关性一致。联合模型的AUC为0.798（95% CI，0.736-0.851），表明具有中等判别能力。较高的NLR还与更重的睡眠呼吸障碍和夜间低氧负荷相关。
结论： 在该单中心急性缺血性卒中队列中，BMI、打鼾和NLR与中重度OSA相关。其联合判别效能为中等。这些观察性发现具有假设生成性，在临床应用前需要前瞻性多中心验证。
英文摘要
OBJECTIVE: To examine the associations of readily available clinical indicators and the neutrophil-to-lymphocyte ratio (NLR) with moderate-to-severe obstructive sleep apnea (OSA) in patients with acute ischemic stroke and to explore the discriminatory performance of BMI, NLR, and a combination of BMI, snoring, and NLR.
METHODS: This single-center retrospective study included 220 patients with acute ischemic stroke who completed overnight polysomnography during hospitalization between October 2024 and April 2026. Moderate-to-severe OSA was defined as an apnea-hypopnea index ≥15 events/h. Clinical characteristics, laboratory indicators, and polysomnographic parameters were compared between groups. Multivariable logistic regression was used to evaluate factors associated with moderate-to-severe OSA, and receiver operating characteristic analysis assessed discriminatory performance. Spearman correlation and NLR tertile analyses explored the relationships between NLR and sleep-disordered breathing and nocturnal hypoxia.
RESULTS: Moderate-to-severe OSA was present in 109 of 220 patients (49.5%). After multivariable adjustment for prespecified clinical covariates, higher BMI (aOR 1.204, 95% CI 1.088-1.332), snoring (aOR 2.910, 95% CI 1.485-5.705), and higher NLR (aOR 2.291, 95% CI 1.449-3.622) remained associated with moderate-to-severe OSA. Modified Poisson sensitivity analyses yielded consistent associations for BMI, snoring, and NLR. The combined model had an AUC of 0.798 (95% CI, 0.736-0.851), indicating moderate discriminatory ability. Higher NLR was also associated with greater sleep-disordered breathing and nocturnal hypoxia burden.
CONCLUSION: BMI, snoring, and NLR were associated with moderate-to-severe OSA in this single-center acute ischemic stroke cohort. Their combined discriminatory performance was moderate. These observational findings are hypothesis-generating and require prospective multicenter validation before clinical application.