目的 探讨脂蛋白相关磷脂酶A2（Lp⁃PLA2）对阻塞性睡眠呼吸暂停低通气综合征（OSAHS） 患者伴缺血性脑血管病（ICVD）的预测作用。方法 回顾性分析 93 例 OSAHS 患者的临床资料，根据其是 否患有 ICVD，分为 OSAHS 伴 ICVD 组（38 例）和 OSAHS 不伴 ICVD 组（55 例）。比较 2 组人口统计学资料、 血管危险因素、Lp⁃PLA2 水平的差异，并通过二元 logistic 回归分析和受试者工作特征曲线（ROC）分析 Lp⁃PLA2 对 OSAHS 患者伴 ICVD 的预测作用。结果 （1）与 OSAHS 不伴 ICVD 组相比，OSAHS 伴 ICVD 组的年龄较大，呼吸暂停⁃低通气指数（AHI）、氧饱和度指数（ODI）及 Lp⁃PLA2 水平较高，高血压病的患 病率较高（P < 0.05）。（2）logistic 回归分析发现年龄越小、AHI 越低是 OSAHS 患者合并 ICVD 的保护因素， Lp⁃PLA2 升高是 OSAHS 患者伴 ICVD 的危险因素。（3）Lp⁃PLA2 预测 OSAHS 患者伴 ICVD 的 ROC 曲线下面 积为 0.805（95%CI：0.710 ~ 0.880，P < 0.001），Lp⁃PLA2 最佳预测值为 257.39 ng/mL（敏感度 86.8%，特异度 67.3%）。结论 Lp⁃PLA2 与 OSAHS 患者 ICVD 的发生有关，升高的 Lp⁃PLA2 水平可能对 OSAHS 患者伴 ICVD 具有一定的预测价值。

Objective To investigate the predictive effect of lipoprotein ⁃ associated phospholipase A2 （Lp ⁃ PLA2）on patients with obstructive sleep apnea syndrome（OSAHS）with ischemic cerebrovascular disease （ICVD）. Methods The clinical data of 93 patients with OSAHS were retrospectively analyzed. According to whether they had ICVD or not，they were divided into OSAHS with ICVD group（38 cases）and OSAHS without ICVD group（55 cases）. The differences in demographic data，vascular risk factors and Lp⁃PLA2 levels were ana⁃ lyzed，and the predictive effect of Lp⁃PLA2 on ICVD in OSAHS patients was analyzed by binary Logistic regression analysis and receiver operating characteristic curve（ROC）. Results （1）Compared with the OSAHS without ICVD group，the OSAHS with ICVD group was older，with higher levels of Apnea⁃hypopnea index（AHI），oxygen desat⁃ uration index（ODI），and Lp⁃PLA2，and a higher prevalence of hypertension. The difference was statistically sig⁃ nificant（P < 0.05）.（2）Logistic regression analysis showed that the younger the age，the lower the AHI were pro⁃ tective factor for patients with OSAHS complicated with ICVD. The elevated Lp⁃PLA2 was a risk factor for patients with OSAHS complicated with ICVD.（3）The area under the ROC curve of Lp⁃PLA2 for predicting ICVD in patients with OSAHS was 0.805（95%CI：0.710 ~ 0.880，P < 0.001），and the best predictive value of Lp⁃PLA2 was 257.39 ng/mL（sensitivity 86.8%，specificity 67.3%）. Conclusion Lp⁃PLA2 is related to the occurrence of ICVD in OSAHS patients，and elevated Lp⁃PLA2 levels may have certain predictive value for OSAHS patients with ICVD.