夜间血氧饱和度监测联合STOP-bang问卷、Epworth嗜睡量表在心血管疾病中筛查阻塞性睡眠呼吸暂停综合征的应用  

Application of nocturnal oximetry monitoring combined with stop-Bang,Epworth Sleepiness Scale in the screening of obstructive sleep apnea in cardiovascular patients

作　　者：邓锐[1] 饶隽[1] 李怡[1] 卢硕颖 陈曦[1] 杨艳 周希林 贺佳 俞晶蓉 刘伟[1] 

机构地区：[1]四川省第五人民医院,四川成都610031

出　　处：《实用医院临床杂志》2017年第6期236-238,共3页Practical Journal of Clinical Medicine

基　　金：四川省干部保健科研课题(编号:川干研2016-401)

摘　　要：目的探讨血氧饱和度结合STOP-bang问卷、Epworth嗜睡量表在心血管疾病中进行阻塞性睡眠呼吸暂停综合征(OSA)疾病筛查的应用价值。方法选取2015年1月至2017年2月在我院就诊的患有心血管疾病的打鼾患者200例,所有患者进行STOP-bang问卷、Epworth嗜睡量表、连续血氧饱和度监测,最后均进行PSG监测后分成单纯鼾症组(<5次/h)、轻度OSA组(~15次/小时)、中度OSA组(~30次/小时)、重度OSA组(>30次/小时),比较各组问卷初筛与连续血氧监测筛查OSA的差异性。结果 STOP-bang问卷阳性筛出率均显著高于Epworth嗜睡量表及血氧饱和度监测(P<0.05);血氧饱和度监测与Epworth嗜睡量表差异无统计学意义(P>0.05)。当三项联合时,敏感性、特异性均高于单项(P<0.05)。结论 STOP问卷、Epworth嗜睡量表、连续血氧监测在心血管疾病中初步筛查和诊断OSA中具有一定的价值,三者联合,可以提高OSA检出率。Objective To evaluate the clinical utility of nocturnal oximetry monitoring combined with questionnaires in the screening of obstructive sleep apnea （OSA） in cardiovascular patients. Methods A total of 200.consecutive cardiovascular patients with suspected OSA from January 2015 to February 2017 were recruited into this study. Two questionnaires of STOP-Bang and Epworth Sleepiness Scale and nocturnal oximetry monitoring were completed. All patients finished the overnight polysomnography （PSG）. Based on the severity of OSA which was determined by apnea hypopnea index （AHI） , the patients were classified into four groups of primary snoring （〈5 events/h） ,mild （ - 15 events/h） ,moderate （ -30 events/h） and severe OSA （ ≥30 events/h）. Then,the differences in the screening rate were compared. Results The positive screening rate of OSA by STOP-Bang questionnaire was significantly higher that by Epworth Sleepiness and nocturnal oximetry monitoring （ P 〈 0. 05 ）. There was no difference in positive screening rate of OSA between Epworth Sleepiness Scale and nocturnal oximetry monitoring （ P 〉 0.05 ）. The sensitivity and the specificity were all increased significantly after the combination of the three methods when compared to single method. Conclusion STOP-Bang, Epworth Sleepiness Scale and nocturnal oximetry monitoring all have a clinical utility. However, the combination of the three may have better accuracy.

关 键 词：阻塞性睡眠呼吸暂停综合征 夜间连续血氧饱和度 STOP-bang问卷 EPWORTH嗜睡量表 

分 类 号：R767.1[医药卫生—耳鼻咽喉科]