摘要
目的比较NoSAS与No-apnea评分在以脑梗死患者为基础的阻塞性睡眠呼吸暂停(OSAHS)筛查中的应用价值。方法回顾性分析广东医科大学附属第二医院睡眠疾病研究所2014年1月1日至2018年12月30日使用多导睡眠监测仪(PSG)监测的脑梗死患者221例可疑OSAHS患者资料,包括NoSAS评分及No-apnea评分的全部项目及患者一般资料。根据呼吸暂停低通气指数(AHI)将患者分为单纯鼾症组(<5次/h)、轻度OSAHS组(AHl5~<15次/h)、中度OSAHS组(AHl15~<30次/h)、重度OSAHS组(AHI≥30次/h)。统计各问卷筛查OSAHS的敏感度、特异度、阳性预测值及阴性预测值,并且绘制ROC曲线,比较各问卷筛查OSAHS的效能。结果以AHI≥5为诊断OSAHS的标准,NOSAS评分的ROC曲线下面积(AUC)为0.831,No-apnea评分的AUC为0.626,预测效能稍差。NoSAS评分预测轻、中、重度OSAHS患者的敏感度为0.867、0.888、0.369,特异度为0.731、0.476、0.369;No-apnea评分预测轻、中、重度OSAHS患者的敏感度为0.897、0.940、0.931,特异度为0.268、0.238、0.181。结论对怀疑患有OSAHS的脑梗死患者,NoSAS评分的预测价值优于No-apnea评分。NoSAS问卷作为一种简明有效的筛查工具,其在脑梗死人群快速筛查OSAHS患者的效果较好,可有效帮助临床医师快速筛查OSAHS。
Objective To compare the application evaluate of the NoSAS and No-apnea score in screening obstructive sleep apnea-hypopnea syndrome (OSAHS) in patients with cerebral infarction. Methods The clinical data of 221 cerebral infarction with patients suspected OSAHS who underwent an overnight polysomnography (PSG) monitoring from January 2014 to December 2018 at the Institute of Sleep Disorders of the Second Affiliated Hospital of Guangdong Medical University were retrospectively analyzed, including all items of the NoSAS score and No-apnea score as well as the general data of the patients. The patients were divided into Snoring Group (<5 times/h), Mild OSAHS Group (5-<15 times/h), Moderate OSAHS Group (15-30 times/h) and Severe OSAHS Group (≥30 times/h) according to apnea hypopnea index (AHI). The sensitivity, specificity, positive predictive value and negative predictive value of the five questionnaires in screening OSAHS were counted and the ROC curve was drawn to compare the efficacy of the five questionnaires in screening OSAHS. Results Using AHI≥5 as the standard for diagnosing OSAHS, the NoSAS score had an AUC of 0.831, the No-apnea score had an AUC of 0.626, and NoSAS score had a better predictive value than the No-apnea score. The sensitivity of the NoSAS score in predicting patients with mild, moderate and severe OSAHS was 0.867, 0.888 and 0.369, respectively, and the specificity of the NoSAS score in predicting patients with mild, moderate and severe OSAHS was 0.731, 0.476 and 0.369, respectively. The sensitivity of the No-apnea score in predicting patients with mild, moderate and severe OSAHS was 0.897, 0.940 and 0.931, respectively, and the specificity of the NoSAS score in predicting patients with mild, moderate and severe OSAHS was 0.268,0.238 and 0.181, respectively. Conclusion For the cerebral infarction patients suspected of OSAHS, the NoSAS score has a better predictive value than No-apnea score. The NoSAS questionnaire can be used as a new simple, effective and practical screening tool. It has good effect in rapidly screening OSAHS in cerebral infarction patients and can effectively help clinicians quickly screening of OSAHS.
作者
陈庞何
陈艳
苏成标
郑珍珍
陈韬
刘旺
陈日垦
成俊芬
CHEN Pang-he;CHEN Yan;Su Cheng-biao;ZHENG Zhen-zhen;CHEN Tao;LIU Wang;CHEN Ri-ken;CHENG Jun-fen(Department of Emergency, the Second Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China;Department of Neurology, the Second Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China;Department of Respiration, the Second Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, China)
出处
《广东医科大学学报》
2019年第4期375-379,共5页
Journal of Guangdong Medical University
基金
广东医科大学科研基金项目(No.GDMUM201836)
