【摘要】 目的比较评价Epworth嗜睡量表(ESS)和STOP-Bang问卷(SBQ)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的筛查作用。方法以148例疑诊OSAHS的患者为研究对象,接受ESS和SBQ评分以预测OSAHS高风险,并进行整夜多导睡眠监测(PSG)。根据PSG检测结果将患者分为单纯鼾症组和OSAHS组,比较两组间ESS评分、SBQ评分及其所预测OSAHS高风险患者所占比率的差异,分析两者预测OSAHS的准确性,受试者工作特征曲线(ROC)评价两者对OSAHS的筛查诊断价值。结果 OSAHS组ESS评分和SBQ评分均显著高于单纯鼾症组[(9.79±4.70)vs.(7.03±4.16),P<0.01和(4.31±1.55)vs.(2.67±1.35),P<0.01]。经SBQ(≥3分)预测为OSAHS高风险者在OSAHS组中所占比率明显高于单纯鼾症组(85.59%vs.46.67%,P<0.01),而经ESS(≥9分)预测为OSAHS高风险者的比率在两组间无显著性差异(57.63%vs.40.00%,P>0.05)。以SBQ(≥3分)判定呼吸暂停低通气指数(AHI)≥5病例,其灵敏度、阴性预测值、与金标准诊断的符合率均高于ESS(≥9分)对AHI≥5病例的预测(85.59%vs.57.63%,48.48%vs.26.47%,79.05%vs.58.11%),SBQ问卷诊断OSAHS的ROC曲线下面积亦高于ESS量表(0.782 6 vs.0.671 0)。结论 ESS评分的显著升高对OSAHS患者的区分判断具有一定意义,但对OSAHS预测的准确性较差,以ESS≥9作为分界来筛查OSAHS也并不可靠;SBQ对OSAHS的预测较ESS具有更高的灵敏度和准确度,是一个较好的OSAHS筛查工具。更多还原

【Abstract】 Objective To compare the value of Epworth Sleepiness Scale(ESS)vs.STOP-Bang Questionnaire(SBQ)in screening obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 148 cases of suspected OSAHS were included in this study.ESS and SBQ were filled before polysomnography(PSG)monitoring.According to the PSG results the patients were divided into primary snoring and OSAHS groups.The average ESS scores,SBQ scores and the ratio of the patients who were predicted at high risk of OSAHS by ESS and SBQ were compared between two groups respectively.The accuracy of ESS and SBQ was analyzed and predictive significance was evaluated.Results The ESS and SBQ scores of the OSAHS group were significantly higher than the primary group [(9.79±4.70 vs.(7.03±4.16),P<0.01;(4.31±1.55) vs.(2.67±1.35),P<0.01].The ratio of the patients with high risk of OSAHS predicted by SBQ(≥3)in the OSAHS group was significantly higher than that in the primary group(85.59% vs.46.67%,P<0.01),but no difference in the ratios predicted by ESS(≥9)was found between the two groups(57.63% vs.40.00%,P>0.05).The sensitivity,negative predictive value and agreement rate of SBQ for an AHI of ≥5 were higher than those of ESS(85.59% vs.57.63%,48.48% vs.26.47%,79.05% vs.58.11%).SBQ had a greater area under receiver operating curve(ROC)than ESS for identification of case with apnea-hypopnea index(AHI)≥5(0.782 6 vs.0.671 0).Conclusion The ESS has some significance but low accuracy in screening OSAHS patients.The ESS score≥9 as a cutoff is not a reliable parameter to estimate OSAHS.The SBQ performed better than the ESS with higher sensitivity and accuracy,thus it is a better choice than the ESS in screening OSAHS.更多还原