血清PTX3联合CHA2DS2-VASc评分对OSAHS合并房颤患者发生脑梗死的预测价值

目的 探讨血清正五聚蛋白-3（PTX3）联合CHA2DS2-VASc 评分对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并房颤患者发生脑梗死的预测价值。方法 选取OSAHS合并房颤患者198例，根据随访期间是否发生脑梗死分为脑梗死组（36例）和无脑梗死组（162例）。比较脑梗死组和无脑梗死组的各项指标，分析OSAHS合并房颤患者血清PTX3水平与其他指标的相关性，Logistic回归分析OSAHS合并房颤患者发生脑梗死的危险因素，受试者工作特征曲线分析PTX3联合CHA2DS2-VASc评分对OSAHS合并房颤患者发生脑梗死的预测价值。结果 脑梗死组的收缩压、低密度脂蛋白胆固醇（LDL-C）、左心房内径（LAD）、呼吸暂停低通气指数（AHI）、CHA2DS2-VASc评分以及PTX3水平均高于无脑梗死组（P＜0.05）；OSAHS合并房颤患者血清PTX3水平与LDL-C、LAD、AHI、CHA2DS2-VASc评分均呈正相关（P＜0.05）；多因素Logistic回归分析显示，较高水平的AHI、CHA2DS2-VASc评分以及PTX3均为OSAHS合并房颤患者发生脑梗死的危险因素（P＜0.05）；PTX3与CHA2DS2-VASc评分预测OSAHS合并房颤患者发生脑梗死的曲线下面积分别为0.785（0.695~0.875）和0.794（0.698~0.890），两者联用分析后敏感度和约登指数均有了明显的提升。结论 血清PTX3联合CHA2DS2-VASc评分对OSAHS合并房颤患者发生脑梗死的预测价值较高。

Predictive value of serum pentraxin-3 combined with CHA2DS2-VASc score for cerebralinfarction in patients with obstructive sleep apnea hypopnea syndrome and atrial fibrillation

Objective To investigate the prediction value of serum pentraxin 3 (PTX3) combined with CHA2DS2-VASc score for cerebral infarction in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and atrialfibrillation. Methods A total of 198 OSAHS patients with atrial fibrillation were selected. According to whether cerebralinfarction occurred during the follow-up period, patients were divided into the cerebral infarction group (36 cases) and thenon-cerebral infarction group (162 cases). The indexes were compared between the cerebral infarction group and the noncerebral infarction group. The correlation between serum PTX3 and other indexes in OSAHS patients with atrial fibrillationwere analyzed. The risk factors of cerebral infarction in OSAHS patients with atrial fibrillation were analyzed. The predictivevalue of PTX3 combined with CHA2DS2-VASc score for cerebral infarction in patients with OSAHS complicated with atrialfibrillation was analyzed. Results The systolic blood pressure, low density lipoprotein cholesterol (LDL-C), left atrialdiameter (LAD), apnea hypopnea index (AHI), CHA2DS2- VASc score and PTX3 were significantly higher in the cerebralinfarction group than those in the non-cerebral infarction (P＜0.05). Serum PTX3 levels were positively correlated withLDL-C, LAD, AHI and CHA2DS2-VASc scores in patients with OSAHS and atrial fibrillation (P＜0.05). MultivariateLogistic regression analysis showed that the increased LAD, AHI, CHA2DS2-VASc score and PTX3 were risk factors forcerebral infarction in patients with OSAHS and atrial fibrillation (P＜0.05). The areas under the curve of PTX3 andCHA2DS2-VASc scores in predicting cerebral infarction in patients with OSAHS complicated with atrial fibrillation were 0.785 (0.695-0.875) and 0.794 (0.698-0.890), respectively. The combined analysis of PTX3 and CHA2DS2-VASc scoresshowed that the sensitivity and Youden index were significantly improved. Conclusion Serum PTX3 combined withCHA2DS2-VASc score has a higher predictive value for cerebral infarction in patients with OSAHS and atrial fibrillation.