STOP-Bang问卷在高血压患者中筛查阻塞性睡眠呼吸暂停低通气综合征的价值

Value of STOP-Bang questionnaire in screening obstructive sleep apnea hypopnea syndrome in hypertensive patients

目的：评价STOP－Bang问卷在高血压患者中筛查阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）的价值。方法选取2014年6月至2015年12月220例因高血压病就诊于扬州市第一人民医院心血管内科、疑诊OSAHS来呼吸科行多导睡眠监测（ PSG）的患者，行STOP－Bang问卷评分，并根据PSG监测结果将患者分为非OSAHS组及轻、中、重度OSAHS组，分析问卷结果与PSG结果的相关性，了解STOP－Bang问卷筛查OSAHS的灵敏度、特异度、阳性预测值及阴性预测值，绘制受试者工作特征（ ROC）曲线。结果4组患者 STOP－Bang 评分随严重程度增加而逐渐增高（分别为2．58±0．85，3．28±1．09，4．09±1．13，4．83±1．09），非OSAHS组与其他各组的STOP－Bang评分结果差异均有统计学意义（P＜0．001）。以3分为截断点诊断呼吸暂停低通气指数（ AHI）≥5，＞15，＞30的灵敏度分别为88．58％，95．52％和98．96％。阴性预测值为47．5％，85．0％和97．5％。诊断OSAHS与金标准的符合率达82．73％。当 AHI≥5次／h 时， ROC 曲线下面积为0．844。结论 STOP－Bang问卷可用于筛查高血压患者是否合并OSAHS，其具有较好的可行性和准确性。

Objective To evaluate the predictive value of the STOP-Bang questionnaire in screening obstructive sleep apnea hypopnea syndrome （ OSAHS ） in the patients with hypertension .Methods A total of 220 patients admitted in the Department of Cardiology of the First People ’ s Hospital of Yangzhou from June 2014 to December 2015 due to hypertension but with suspected OSAHS were enrolled in this study .All the subjects were surveyed with STOP-Bang questionnaire , and given polysomnography （PSG）.According to the results of PSG, they were divided into non-OSAHS, and mild, moderate and severe OSAHS groups .The results of STOP-Bang score and PSG were compared and analyzed for the sensitivity , specificity, positive predictive values , negative predictive values and the area under the receiver operating characteristics （ ROC ） curve of the questionnaire . Results The STOP-Bang questionnaire scores were elevated with the increased severity of OSHAS （2.58 ±0.85, 3.28 ±1.09, 4.09 ±1.13 and 4.83 ±1.09）.Significant difference were found in the STOP-Bang scores between the non-OSAHS group and the other 3 OSAHS groups respectively （P〈0.001）.The sensitivities of STOP-Bang scoring model for apnea hypopnea index （AHI）≥5, 〉15, 〉30 were 88.58%, 95.52%and 98.96%respectively, and the negative predictive values were 47.5%, 85.0%and 97.5%respectively. The coincidence rate of STOP-Bang scoring model was 82.73%when compared with gold standard to diagnose OSAHS .The area under the ROC curve at AHI≥5 was 0.844.Conclusion The STOP-Bang questionnaire is suitable to screen OSAHS among hypertensive patients, with sound feasibility and accuracy .