S-B评分量表对OSAHS预测作用的初步评价

Primary evaluation of the simplified Chinese version of STOP-Bang scoring model in predicting obstructive sleep apnea hypopnea syndrome

目的:初步评价简体中文版STOP-Bang(S-B)评分量表对OSAHS的预测价值。方法:114例疑诊OSAHS的患者接受简体中文版S-B量表评分,并进行整夜PSG监测。根据PSG监测结果将患者分为单纯鼾症组及轻、中、重度OSAHS组,比较4组间S-B评分及OSAHS高风险(评分≥3分)患者所占的比率,分析S-B量表对OSAHS的预测作用。结果:114例患者中,经S-B量表预测为OSAHS高风险者89例(78.1%)。S-B评分随OSAHS病情加重有逐渐增加趋势(4组的S-B评分分别为:2.74±1.39、3.25±1.16、4.30±1.20、4.79±1.41),中、重度OSAHS组的S-B评分与单纯鼾症组、轻度OSAHS组之间的差异均有统计学意义(均P<0.01)。OSAHS组经S-B预测高风险的患者所占比率(85.7%)显著高于单纯鼾症组(47.8%)(P<0.01)。以S-B评分≥3分诊断AHI≥5、≥15和≥30的灵敏度分别85.7%、92.5%和100.0%,阴性预测值分别为48.0%、80.0%和100.0%,诊断OSAHS与金标准的符合率达78.9%。以AHI≥5为诊断标准,ROC曲线下面积为0.774。结论:简体中文版S-B评分量表可用以评估患者是否存在OSAHS高风险。它简明易用,具有高灵敏度和高阴性预测值,是一个较好的筛查和预测中重度OSAHS的工具。

Objective：To evaluate the predictive significance of the simplified Chinese STOP-Bang（S-B） scoring model in predicting obstructive sleep apnea hypopnea syndrome（OSAHS）.Method：A total of 114 cases with suspected OSAHS were included in this study.S-B questionnaire was filled before polysomnography（PSG） monitoring.According to the PSG monitoring results the patients were divided into simple snoring,mild,moderate and severe OSAHS groups.The average S-B scores and the ratio of patients with S-B score ≥3 were compared among the four groups respectively.The accuracy of S-B scoring model was analyzed and predictive significance was evaluated.Result：Eighty nine of 114（78.1%） patients were classified as being at high risk of OSAHS by S-B scoring.The S-B scores showed an accrescent tendency as the severity of OSAHS increased.The scores in the four groups were 2.74±1.39,3.25±1.16,4.30±1.20,4.79±1.41 respectively.Significant difference in S-B scores was found between severe OSAHS group and the other three groups respectively（P〈0.01）,and also between moderate OSAHS group and mild OSAHS/simple snoring group（P〈0.01）.The ratio of patients with high risk of OSAHS predicted by S-B scoring in OSAHS group（85.7%） was significantly higher than that in simple snoring group（47.8%）（P〈0.01）.The sensitivities of S-B scoring model for AHI≥5,≥15 and ≥30 were 85.7%,92.5% and 100%,respectively;the negative predictive values were 48.0%,80.0% and 100%.The coincidence rate of S-B scoring model with golden standard to diagnose OSAHS was 78.9%.The area under the ROC curve at AHI cutoff of greater than or equal to 5 was 0.774.Conclusion：S-B scoring model can be used to evaluate patients with high risk of OSAHS.It is a concise and easy-to-use tool to screen and predict moderate and severe OSAHS with relative high sensitivity and negative predictive value.