修改后Berlin量表诊断成人OSAHS的准确性研究

Evaluation of the diagnostic accuracy of modified Berlin questionnaire on predicting obstructive sleep apnea-hypopnea syndrome in adults

目的:评估修改后Berlin量表诊断中国成年人OSAHS的准确性。方法:根据亚太地区肥胖定义,将原Berlin量表的BMI切点值调整至25.0。以244例接受PSG的患者作研究对象,将其填写的原Berlin量表结果和修改后Berlin量表结果分别与PSG结果相比较,评价修改后Berlin量表诊断中国成年人OSAHS的准确性。结果:以AHI≥5为OSAHS的诊断切点值。男性受试者中,原Berlin量表诊断OSAHS的敏感度和特异度分别为74.03%和65.71%,诊断一致性百分率为72.49%,Kappa系数为0.304(P<0.01);修改后Berlin量表对男性受试者的诊断敏感度和特异度分别为92.21%和48.57%,诊断一致性百分率为84.13%,Kappa系数为0.437(P<0.01)。女性受试者中原Berlin量表诊断OSAHS的敏感度和特异度分别为50.00%和61.90%,诊断一致性百分率为54.55%,Kappa系数为0.110(P>0.01);修改后Berlin量表对女性受试者的诊断敏感度和特异度分别为76.47%和47.62%,诊断一致性百分率为65.45%,Kappa系数为0.248(P>0.01)。结论:在男性人群中,修改后Berlin量表较原量表在诊断OSAHS方面具有更好的诊断一致性;在女性人群中,尽管修改后Berlin量表较原量表在诊断一致性上有所提高但仍不理想,尚需进一步探索适合我国女性人群的OSAHS筛查工具。

Objective：To evaluate the diagnostic value of modified Berlin questionnaire on predicting obstructive sleep apnea-hypopnea syndrome（OSAHS）in Chinese adults.Method：Differ from the original version,BMI cutoff point was adjusted to 25.0in modified Berlin questionnaire according to the Asia-Pacific obesity definition.A total number of 244 samples who experienced polysomnography（PSG）were included.After well informed,each patient finished questionnaire by an interview.The results of the original and modified questionnaires and polysomnography reports were compared with polysomnography reports to evaluate the diagnostic accuracy of the modified Berlin questionnaire.Result：In male population,the sensitivity and specificity of original Berlin questionnaire were74.03%and 65.71%,respectively.The percentage of diagnostic consistency was 72.49%,and Kappa coefficient was 0.304（P〈0.01）.In aspect of modified version,the sensitivity and specificity were 92.21% and 48.57%.The percentage of diagnostic consistency was 84.13%,and Kappa coefficient was 0.437（P〈0.01）.In female population,the sensitivity and specificity of original version were 50.00% and 61.90%,respectively.The percentage of diagnostic consistency was 54.55%,and Kappa coefficient was 0.110（P〉0.01）.When comes to the modified Berlin questionnaire,the sensitivity and specificity were 76.47 % and 47.62%in female subjects,and the percentage of consistency agreement was 65.45%,with a Kappa coefficient 0.248（P〉0.01）.Conclusion：Compared to the original version,the modified Berlin questionnaire has a better diagnostic consistency with a considerable sensitivity and specificity in male population.However,in female subjects group,the consistency of the modified Berlin questionnaire was still not significant remains unsatisfactory,although Pvalue has been improved.Modified Berlin questionnaire could be used as a primary screening tool for male OSAHS patients.However,,but the screening questionnaire for female should still be need to be further explored.