NoSAS评分对阻塞性睡眠呼吸暂停低通气综合征诊断价值的Meta分析

The diagnostic value of No SAS score for obstructive sleep apnea hypopnea syndrome: a meta-analysis

目的系统评价NoSAS评分对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的诊断价值。方法计算机检索Medline、Embase、Web of Science、Cochrane Library、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(WanFang Data)、维普中文科技期刊数据库(VIP),检索关于NoSAS评分诊断OSAHS的诊断性研究,检索时间为2016年1月~2021年7月。由2名评价员独立筛选文献、提取资料,并进行纳入研究质量评价后进行Meta分析。结果共纳入13个研究,包含19 029 例患者。Meta分析结果显示,NoSAS评分诊断轻、中、重度OSAHS、中、重度OSAHS、重度OSAHS的合并敏感度(Sen)分别为0.71,95%CI(0.70-0.71)、0.78,95%CI(0.77-0.79)、0.83,95%CI(0.82-0.84);合并特异度(Spe)分别为0.70,95%CI(0.69-0.72)、0.58,95%CI(0.57-0.59)、0.50,95%CI(0.49-0.51);合并诊断比值比(DOR)分别为5.04,95%CI(4.45-5.70)、4.33,95%CI(3.73-5.03)、4.00,95%CI(3.12-5.13);受试者工作特征曲线下面积(AUC)分别为0.745、0.733、0.702。诊断准确性欧美人群优于亚洲人群。结论 NoSAS评分是一个快速简洁的筛查工具,具有较高的敏感度和一定的特异度,对OSAHS的临床初步筛查有较高的应用价值,值得临床推广使用。

OBJECTIVE To systematically review the diagnostic value of NoSAS score for diagnosing OSAHS.METHODS Medline,Embase,Web of Science,Cochrane Library,CNKI,CBM,Wanfang Data and VIP databases were searched to collect studies on the NoSAS score in the diagnosis of OSAHS from January 2016 to July 2021.Two reviewers independently screened the literature,extracted the data,the quality of included study was evaluated,then the meta-analysis was performed.RESULT A total of 13 studies were enrolled,including 19029 patients.The results of meta-analysis showed that the pooled sensitivity of NoSAS score in diagnosing mild OSAHS,moderate OSAHS and severe OSAHS was 0.71(95%CI:0.70-0.71),0.78(95%CI:0.77-0.79) and 0.83(95%CI:0.82-0.84),the pooled specificity were 0.70(95%CI:0.69-0.72),0.58(95%CI:0.57-0.59) and 0.50(95%CI:0.49-0.51),the pooled DOR were 5.04(95%CI:4.45-5.70),4.33(95%CI:3.73-5.03) and 4.00(95%CI:3.12-5.13),and the AUC of SROC were 0.745,0.733 and 0.702,respectively.The diagnostic accuracy in European and American populations were superior to that in Asian population.CONCLUSION The NoSAS score is a rapid and simple screening tool with higher sensitivity and certain specificity,and it has high application value for the initial clinical screening of OSAHS,and should be popularized in clinical settings.