STOP-Bang问卷筛查重叠综合征的临床价值研究

发布时间：2018-03-13 01:26

  本文选题：睡眠呼吸暂停　切入点：阻塞性　出处：《中国全科医学》2017年35期 　论文类型：期刊论文

【摘要】：目的评价STOP-Bang问卷(SBQ)用于筛查重叠综合征(OS)的临床价值。方法选取2015年6月—2017年4月在无锡市人民医院呼吸科就诊且疑诊OS的慢性阻塞性肺疾病(COPD)患者320例,患者均接受多导睡眠监测(PSG)检查,并同时在专业医护人员指导下填写SBQ,分析两者相关性。并根据睡眠呼吸暂停低通气指数(AHI)将患者分为5≤AHI≤15、15AHI≤30、AHI30 3组,分析SBQ预测OS的灵敏度、特异度、阳性预测值和阴性预测值,并绘制受试者工作特征(ROC)曲线。结果 SBQ与年龄、第1秒用力呼气末容积(FEV1)/用力肺活量(FVC)、混合性呼吸暂停指数(MAI)无直线相关关系(r_s=0.061,P=0.279;r_s=-0.910,P=0.102;r_s=0.181,P=0.511);SBQ与体质指数(BMI)、AHI、低通气指数(HI)、阻塞性睡眠呼吸暂停指数(OAI)、中枢性呼吸暂停指数(CAI)、氧减指数(ODI)呈正相关(r_s=0.032,P0.001;r_s=0.538,P0.001;r_s=0.403,P0.001;r=0.526,P0.001;r_s=0.265,P0.001;r_s=0.506,P0.001);SBQ与FEV1呈负相关(r_s=-0.130,P=0.016)。SBQ诊断OS的灵敏度为99.2%,特异度为85.6%,阳性预测值为80.1%,阴性预测值为99.4%。SBQ预测5≤AHI≤15的OS患者的ROC曲线下面积(AUC)为0.915(0.737,0.957),最佳诊断界值为2分;预测15AHI≤30的OS患者的AUC为0.861(0.812,0.910),最佳诊断界值为5分;预测AHI30的OS患者的AUC为0.769(0.641,0.895),最佳诊断界值为6分。结论筛查OS时,SBQ与PSG主要检查指标具有相关性,是一个较好的筛查和预测OS的工具,值得临床推广。
[Abstract]:Objective to evaluate the clinical value of STOP-Bang questionnaire for screening overlap syndrome. Methods 320 patients with chronic obstructive pulmonary disease (COPD) with suspected OS were selected from June 2015 to April 2017 in Department of Respiratory, Wuxi people's Hospital. All patients were examined with PSG, and at the same time, the patients were filled in SBQs under the guidance of professional medical staff, and the correlation between them was analyzed. According to the sleep apnea hypopnea index (AHII), the patients were divided into 5 鈮，

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