STOP-Bang问卷、脉搏血氧仪对睡眠呼吸暂停综合征诊断价值

The Diagnostic Value of Stop-bang Questionnaire and Pulse Oximeter for Sleep Apnea Syndrome

目的:了解STOP-Bang问卷、脉搏血氧仪联合应用对睡眠呼吸暂停综合征的诊断价值。方法:选取2017年3月至2019年10月北京市顺义区24个社区和乡镇卫生院进行睡眠呼吸暂停综合征(OSAS)健康宣教过程中同时进行STOP-Bang问卷调查,以随机方式进行脉搏血氧仪和便携式睡眠记录仪监测,用受试者工作特征曲线(ROC)分析评价STOP-Bang问卷对OSAS的诊断效能,计算STOP-Bang问卷和脉搏血氧仪联合应用诊断OSAS的敏感性和特异性等指标。结果:共1218例完整填写STOP-Bang问卷,男499例(40.97%),平均年龄(51±16)岁,女719例(59.03%),平均年龄(48±16)岁,有高血压458例(37.60%),体质量指数大于35 kg/m^(2)379例(31.12%),颈围大于40 cm 221例(18.14%),其中593例行脉搏血氧仪监测及便携式睡眠记录仪检测。根据约登指数计算ROC曲线诊断STOP-Bang最佳评分界值为3.5,此时灵敏度为70.7%,特异度为71.2%。STOP-Bang诊断OSAS的灵敏度71.50%、特异度40.61%,脉搏血氧仪敏感度85.75%,特异性64.85%,两者联合应用并联试验敏感性93.46%,串联试验特异性92.73%。结论:脉搏血氧仪诊断OSAHS的灵敏度、特异度等指标均超过STOP-Bang问卷,两项筛检试验联合应用,基本可以达到诊断OSAS的效果,可以起到节约医疗资源的作用。

Objective:To investigate the diagnostic value of stop-bang questionnaire and pulse oximeter for sleep apnea syndrome.Methods:From March 2017 to October 2019,24 community and township health centers in Shunyi District of Beijing were selected to conduct a stop Bang questionnaire survey during the health education of OSAS.Pulse oximeter and portable sleep recorder were monitored in a random way.Receiver operating characteristic curve(ROC)analysis was used to evaluate the diagnostic efficacy of stop Bang questionnaire for OSAS,The sensitivity and specificity of stop Bang questionnaire combined with pulse oximeter in diagnosis of OSAS were calculated.Results:A total of 1218 people was completed the STOP-Bang questionnaire,including 499 males(40.97%),with an average age of(50±16)years,719 females(59.03%),an average age of(48±16)years,458 patients(37.60%)with hypertension,379 patients(31.12%)with body mass index greater than 35 kg/m^(2),221 patients(18.14%)with neck circumference greater than 40 cm.593 of which were monitored by pulse oximeter and portable sleep recorder.According to Jordan index,ROC curve was used to calculate the best score boundary value for STOP-Bang diagnosis,which was 3.5.At this time,the sensitivity is 70.7%,and the specificity was 71.2%.The sensitivity and specificity of STOP-Bang in the diagnosis of OSAS were 71.50%and 40.61%,85.75%and 64.85%for pulse oximeter,93.46%and 92.73%for parallel test and series test respectively.Conclusion:The sensitivity and specificity of pulse oximeter in the diagnosis of OSAS exceed STOP-Bang questionnaire.The combined application of the two screening tests can basically achieve the effect of OSAS diagnosis and can save medical resources.