改良Epworth嗜睡量表在妊娠合并阻塞性睡眠呼吸暂停低通气综合征中的应用

Clinical application of the modified Epworth Sleepiness Score in the gestation women combined with obstructive sleep apnea-hypopnea syndrome

目的 应用改良Epworth嗜睡量表（ESS）对妊娠合并阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者进行筛查,并评估其效果.方法 选择单纯妊娠组22例、妊娠合并OSAHS（轻度23例、中度22例、重度19例）组64例,采用ESS和改良ESS进行评分得出EP值和改良EP值,并测量颈围（NC）、体质量指数（BMI）,行多导睡眠监测（PSG）并得出呼吸暂停低通气指数（AHI）和最低血氧饱和度（LSaO2）,分析改良ESS和ESS与AHI的相关性并绘制ROC曲线.结果 妊娠合并轻度OSAHS组的EP值与单纯妊娠组差异无统计学意义（P＞0.05）;其余妊娠合并OSAHS组的改良EP、EP值与单纯妊娠组均有统计学意义（均P＜0.05）;改良EP、EP、NC、BMI值与AHI值呈现正相关,相关系数r分别为0.876、0.748、0.671、0.670（均P＜0.001）;改良EP、EP、NC、BMI的曲线下面积（AUC）值为0.901、0.819、0.750、0.779;当改良EP值=8.5时,有较高的灵敏度（84.4%）与特异性（90.9%）.结论 改良ESS对妊娠合并OSAHS的患者有较好的临床筛查价值.

Objective Screening OSAHS patients on pregnancy with Modified Epworth Sleepiness Scale（ Epworth sleepiness scale,ESS）and to assess its effect. Methods 22 patients underwent the pregnancy,and pregnancy with OSAHS（ mild in 23 cases,22 cases of moderate and severe in 19 cases）group were 64 people, By ESS and modified ESS score, EP and modified EP values was derived. The neck circumference （ NC）, body mass index （BMI） was measured. Conduct of polysomnography （ PSG）, apnea hypopnea index （ AHI ） and lowest oxygen saturation （ LSaO2 ）ESS and modified ESS correlation with the AHI was analyzed and ROC curves was drawn. Results The EP value of pregnancy with mild OSAHS group has no significant difference between normal pregnancy group（ P 〉 0.05） ;the rest of pregnancy OSAHS group modified EP, EP values and the normal pregnancy group were significantly different （ all P〈0.05） ;modified EP, EP, NC, BMI values positively correlated with the AHI value, the correlation coefficient r were ：0.876,0.748,0.671,0.670 （ all P 〈 0.001 ） ;modified EP, EP, NC, BM I of the A UC values were 0.901,0.819,0.750, 0.779; when the modified EP = 8.5, had higher sensitivity （ 84.4% ） and specificity （ 90.9% ）.Conclusion Modified ESS on pregnancy OSAHS patients had better clinical value of screening.