目的

探讨血管内皮生长因子（VEGF）、炎症因子（IL-6）在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者诊断及手术治疗中的价值。

方法

选取2022 年6 月～ 2023 年8 月就诊于徐州医科大学附属淮安医院耳鼻咽喉头颈外科的225 例成人OSAHS 手术患者。收集所有患者的一般资料，并检测术前、术后1 周、术后6 个月、术后1 年血清VEGF 和IL-6。采用Logsitic 逐步回归法计算VEGF、IL-6 联合预测OSAHS 患者改善情况的概率值，采用受试者工作特征（ROC）曲线评价各项指标，通过单项检测和联合检测预测OSAHS 患者合并VEGF 及IL-6 水平变化的效能。

结果

与轻度组和中度组相比，重度组患者男性比例更高（81.7%，P=0.048），体重、颈围存在组间差异，重度组的中位体重更高[83（75，90），P=0.023]、颈围更大[42.0（40.0，45.0），P=0.002]。且术前AHI、最低血氧饱和度、平均血氧饱和度、Stop-Bang 评分和Epworth 嗜睡量表等临床参数在各组间均显示出显著差异。重度组在术后各个时间点的VEGF 和IL-6 水平均高于轻度组和中度组，且各时间点、各组内，VEGF、IL-6 均表现出与OSAHS 相关指标有较高相关性。VEGF、IL-6 单项检测和联合检测预测OSAHS 患者的术后6 个月疗效ROC 曲线下面积（AUC）分别为0.746、0.781，联合预测模型的AUC 为0.787。术后1 年疗效ROC 曲线下面积（AUC）分别为0.691、0.723，联合预测模型的AUC 为0.740。与轻中度组患者相比，重度组出现术后并发症人数较多，但差异无统计学意义。

结论

VEGF、IL-6 对预测OSAHS 患者术前病情严重程度及术后预后效果具有重大意义，两者联合临床指标对OSAHS 的诊断及治疗预测效能更高。

Objective

To assess the value of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) in the diagnosis and surgical treatment of obstructive sleep apnea-hypopnea syndrome(OSAHS).

Methods

A total of 225 adult OSAHS patients who underwent surgery at the Department of Otorhinolaryngology, Huaian Hospital Affiliated to Xuzhou Medical University from June 2022 to August 2023 were included in this study. The patients were divided into severe, moderate, and mild groups based on the severity of OSAHS. Demographic and clinical data were collected, and serum levels of VEGF and IL-6 were measured preoperatively and one week, six months, and one year post-surgery. Logistic stepwise regression was employed to assess the predictive ability of combined VEGF and IL-6 levels for postoperative improvement. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of these biomarkers.

Results

Patients with severe OSAHS had a significantly higher male-to-female ratio (81.7%, P=0.048) compared to those with mild and moderate OSAHS. Additionally,patients with severe OSAHS exhibited significantly greater median weight [83 kg (75, 90), P=0.023] and neck circumference [42.0 cm (40.0, 45.0), P=0.002]. Preoperative metrics, including the apnea-hypopnea index (AHI), minimum and average oxygen saturation, Stop-Bang score, and Epworth Sleepiness Scale score, showed significant differences among the groups. Postoperatively, VEGF and IL-6 levels in the severe group remained elevated compared to the mild and moderate groups at all time points, demonstrating a strong correlation with OSAHS-related parameters. The area under the ROC curve (AUC) for predicting sixmonth postoperative efficacy was 0.746 for VEGF, 0.781 for IL-6, and 0.787 for the combined model. For predicting one-year postoperative efficacy, the AUC was 0.691 for VEGF, 0.723 for IL-6, and 0.740 for the combined model. Although the severe group experienced a higher incidence of postoperative complications,the difference was not statistically significant.

Conclusion

VEGF and IL-6 are significant biomarkers in assessing the severity and prognosis of OSAHS. The combined use of these biomarkers, alongside clinical indicators, enhances diagnostic accuracy and prognostic precision in the management of OSAHS.