阻塞性睡眠呼吸暂停中呼吸暂停低通气指数-氧减饱和度指数（AHI-ODI）不一致性：与症状负担及心血管代谢共病的关联：一项回顾性横断面研究
Apnea-hypopnea index-oxygen desaturation index (AHI-ODI) discordance in obstructive sleep apnea: association with symptom burden and cardiometabolic comorbidity: A retrospective cross-sectional study.
文献信息
| PMID | 42901132 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ahmed Ehab |
| 作者单位 | Department of Chest Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt; DGD Hemer Lung Center, Hemer, Germany. Electronic address: dr.a.ehab@gmail.com. |
| 期刊 | Respiratory medicine |
| SCI 分区 | Q2 |
| IF | 3.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 呼吸暂停低通气指数（AHI）计数呼吸事件，但不反映伴随血氧下降的深度或持续时间。我们研究了AHI-ODI不一致性（AHI减去氧减饱和度指数ODI）及其与日间症状负担和现患心血管代谢共病的关联。
方法： 单中心回顾性横断面研究，纳入200例成人OSA患者（2023年1月至2025年1月）。检查了五项指标（AHI、ODI、平均SpO2、T90及AHI-ODI不一致性）；主要结局为日间过度嗜睡（EDS；Epworth嗜睡量表≥11）。多变量logistic回归校正年龄、性别、BMI及AHI-ODI×性别交互作用。
结果： 队列中男性占77.5%，中位年龄57岁（48.8-64.2）。对于EDS，AHI-ODI不一致性显示出数值上最高的AUC（0.639，p<0.001），其次为T90（0.627），平均SpO2和ODI（各0.609）；AHI无统计学意义（0.546，p=0.264）。各指标两两比较均无显著差异。校正后，AHI-ODI不一致性仍与EDS独立相关（每事件/小时OR 1.04，95%CI 1.01-1.07，p=0.008），无显著性别交互作用。在次要结局中，T90对糖尿病（0.644）和高血压（0.615）的AUC最高，平均SpO2对心力衰竭（0.608）最高。无指标可区分既往卒中或心房颤动。
结论： AHI-ODI不一致性与EDS独立但仅轻度相关，而氧合指标与现患心血管代谢共病相关。区分能力不足，所有报告的截断值均为探索性。AHI-ODI不一致性并非睡眠呼吸暂停特异性缺氧负荷的测量指标。
英文摘要
BACKGROUND: The apnea-hypopnea index (AHI) counts respiratory events but not the depth or duration of accompanying desaturation. We examined AHI-ODI discordance (AHI minus oxygen desaturation index, ODI) and its associations with daytime symptom burden and prevalent cardiometabolic comorbidity.
METHODS: Single-center retrospective cross-sectional study of 200 adults with OSA (January 2023-January 2025). Five indices (AHI, ODI, mean SpO2, T90 and AHI-ODI discordance) were examined; excessive daytime sleepiness (EDS; Epworth Sleepiness Scale ≥ 11) was the primary outcome. Multivariable logistic regression adjusted for age, sex, BMI and an AHI-ODI × sex interaction.
RESULTS: The cohort was 77.5% male, median age 57 years (48.8-64.2). For EDS, AHI-ODI discordance showed the numerically highest AUC (0.639, p < 0.001), followed by T90 (0.627), and mean SpO2 and ODI (0.609 each); AHI was not significant (0.546, p = 0.264). No pairwise difference was significant. AHI-ODI discordance remained independently associated with EDS after adjustment (OR 1.04 per event/h, 95% CI 1.01-1.07, p = 0.008), with no significant sex interaction. Among secondary outcomes, T90 showed the highest AUCs for diabetes mellitus (0.644) and hypertension (0.615), and mean SpO2 for heart failure (0.608). No index discriminated against previous stroke or atrial fibrillation.
CONCLUSIONS: AHI-ODI discordance was independently, but only modestly, associated with EDS, whereas oxygenation indices were related to prevalent cardiometabolic comorbidity. The discrimination was insufficient, and all reported cut-offs are exploratory. AHI-ODI discordance is not a measure of sleep apnea-specific hypoxic burden.