Clinical Study Of Neutrophil-to-lymphocyte Ratio And 8-hydroxydeoxyguanosine In Patients With Coronary Heart Disease And OSAHS

ObjectiveTo observe the changes of neutrophil-to-lymphocyte ratio（NLR）and8-hydroxydeoxyguanosine（8-OHdG）in patients with coronary heart disease and obstructive sleep apnea hypopnea syndrome（OSAHS）,simultaneously observe the changes of NLR and 8-OHdG in OSAHS patients with different severities of coronary heart disease,and to explore the changes of inflammatory response and oxidative stress in patients with coronary heart disease and OSAHS,then to provides a reference for clinical screening of indicators of systemic inflammation and oxidative stress in coronary heart disease and OSAHS.Methods110 patients in total undergoing polysomnography（PSG）and coronary angiography at Department of Cardiology,Gansu Provincial Hospital from November2016 to August 2017 were enrolled in this study.According to coronary angiography and PSG results,these patients were divided into:（1）OSAHS group including 30cases（group O）,（2）coronary heart disease group including 30 cases（group C）,（3）coronary heart disease group with OSAHS including 50 cases（group CO）.In addition,30 patients undergo coronary angiography and portable wrist-type sleep monitoring were normal（N group）.The patients’gender,age,smoking,drinking,hypertension and diabetes,as well as baseline data such as body weight,height,blood pressure,heart rate,blood glucose,blood lipids,liver function and renal function were recorded.Berlin questionnaire was scored for all patients,and blood samples were collected to determine the level of NLR and 8-OHdG in each group.All the data were analyzed by statistical software SPSS 20.0.P<0.05 was considered statistically significant.Results1.Comparison among O group,C group,CO group and N group1.1 There was no statistical difference between the four groups in the clinical baseline data such as age,gender,history of diabetes,smoking,LVEF,liver and kidney function,blood lipid levels and HbA1c（P>0.05）,while history of hypertension,systolic blood pressure and diastolic blood pressure on admission,BMI,MSaO₂ and LSaO₂ were statistical different（P<0.05）.1.2 There was significant statistical difference in NLR between the four groups（P=0.024）.The difference of serum 8-OHdG concentration was also statistically significant（P<0.001）.2.Subgroup analysis on CO group patients with different severities of OSAHS2.1 When comparing OSAHS patients in CO group with different age,gender,history of hypertension,history of diabetes,smoking,systolic and diastolic blood pressure on admission,BMI,LVEF,liver and kidney function,blood lipid levels,HbA1c,MSaO₂ and other clinical baseline data,there was no statistical difference between the subgroups（P>0.05）.The difference of LSaO₂ between subgroups was statistically significant（P<0.05）.2.2 In CO group patients with different severities of OSAHS the NLR difference was statistically significant（P=0.002）,and serum 8-OHdG concentration difference was also statistically significant（P<0.001）.2.3 Gensini score of patients in CO group patients with varying degrees of OSAHS had no significant statistical difference（P=0.085）.χ² tests among the three groups of the number of coronary lesions differences were statistically significant（P=0.013）.3.Correlation analysis on patients in CO group3.1 Pearson correlation analysis showed that there was a positive correlation between NLR and serum 8-OHdG level and AHI in CO group（P<0.05）.3.2 Pearson correlation analysis showed that there was no significant correlation between NLR and serum 8-OHdG level and MSaO₂ in CO group（P>0.05）.3.3 Pearson correlation analysis showed that the level of NLR and serum8-OHdG in CO group was negatively correlated with LSaO₂（P<0.05）.4.The Berlin questionnaire confirmed the predictive value of OSAHS for PSGThe Berlin questionnaire predicted the sensitivity of OSAHS was 87.65%,the specificity was 68.97%,the positive predictive value was 88.75%,and the negative predictive value was 66.67%.Conclusion1.NLR and serum 8-OHdG levels of patients with coronary heart disease and OSAHS were significantly elevated.It suggests that in these patients the inflammatory response and oxidative stress response is high,and indicates the detection of NLR and serum 8-OHdG level can act as a clinical alert.2.More serious OSAHS patients are,they have higher level of NLR and serum8-OHdG.There is a correlation between PSG monitoring results such as AHI,LSaO₂,so the detection of NLR and serum 8-OHdG level can reflect the severity of OSAHS.3.Berlin questionnaire has high sensitivity and specificity,and it’s simple and easy.It’s a great significance approach to the screening of OSAHS.