体检人群使用NOSAS评分作为阻塞性睡眠呼吸暂停初筛工具的可行性分析  

Feasibility Analysis of the NOSAS Score as A Screening Tool for Obstructive Sleep Apnea in the Physical Examination Population

作　　者：董文辉[1] 邹煦[1] 巩忠[2] 苏丽琴[3] 李慧英[2] 张晗[1] DONG Wen-hui;ZOU Xu;GONG Zhong;SU Li-qin;LI Hui-ying;ZHANG Han(Health Management Center,Beijing 100076;Neurology Department of Beijing Aerospace General Hospital,Beijing 100076;Indoor Environment and Health Monitoring Unit,Institute of Environmental and Health-Related Product Safety,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]北京航天总医院健康管理中心,北京100076 [2]北京航天总医院神经内科,北京100076 [3]中国疾病预防控制中心环境与健康相关产品安全所,室内环境与健康监测室,北京100050

出　　处：《昆明医科大学学报》2021年第5期48-53,共6页Journal of Kunming Medical University

基　　金：国家重点研发计划基金资助项目(2016YFC1302601)。

摘　　要：目的比较NOSAS评分与STOP-Bang问卷的预测值,对体检人群使用NOSAS评分作为OSAHS初步筛查工具的可行性进行探讨。方法回顾性分析2018年1月至2019年8月来北京航天总医院健康管理中心疑似OSAHS患者135例的多导睡眠图(PSG)监测结果,包括NOSAS评分及STOP-Bang问卷各项目及患者资料。按呼吸暂停低通气指数(AHI)分组。计算NOSAS评分和Stop-Bang问卷的敏感度、特异性、阳性预测值和阴性预测值,并绘制ROC曲线。比较2个评分筛查OSAHS的价值。结果在135例患者中,男性占75.6%,女性占24.4%。以AHI≥5次/h、15次/h、30次/h为诊断标准,NOSAS评分敏感度和特异性分别为:0.891和0.720、0.910和0.587、0.814和0.553;STOP-Bang问卷的敏感性和特异性分别为:0.873和0.560、0.910和0.435、0.949和0.329。当以AHI≥5次/h、15次/h、30次/h为诊断标准,NOSAS评分ROC曲线下面积分别为:0.847、0.773、0.693,差异有统计学意义(P<0.001);STOP-Bang问卷的ROC曲线下面积分别为:0.784、0.711、0.694,差异有统计学意义(P<0.001)。以AHI为5次/h、15次/h及30次/h为临界点时,NOSAS评分ROC曲线下面积大于或等于STOP-Bang问卷评分。NOSAS评分具有良好的预测价值。结论NOSAS评分作为一种简单有效的初筛工具,在健康体检人群可有效的帮助医师快速筛查OSAHS患病高风险者。Objective To compare the predictive value of NoSAS score and STOP-Bang questionnaire score,and evaluate the feasibility of NoSAS score screening for OSAHS in physical examination population.Methods Retrospective analysis of the polysomnography(PSG)monitoring results of 135 patients with suspected OSAHS in our health management center was made from January 2018 to August 2019,including the NOSAS score and the Stop Bang Questionnaire and patient information.Grouped by apnea-hypopnea index(AHI),the sensitivity,specificity,positive predictive value and negative predictive value of NOSAS score and Stop-Bang questionnaire score were calculated,and ROC curves were drawn so as to compare the effectiveness of two scores which screened OSAHS.Result Of the 135 patients,75.6%were male and 24.4%were female.Using AHI≥5 events/h,AHI≥15 events/h and AHI≥30 events/h as the diagnostic criteria,the sensitivity and specificity of NOSAS scores were:0.891 and 0.720,0.910 and 0.587,0.814,and 0.553;The sensitivity and specificity of STOP-Bang questionnaire were 0.873 and 0.560,0.910 and 0.435,0.949 and 0.329,respectively.When AHI≥5 events/h,AHI≥15 events/h and AHI≥30 events/h were used as diagnostic criteria,the areas under ROC curveofthe NoSAS score were 0.847,0.773 and 0.693,the difference was statistically significant(P<0.001);the areas under the ROC curve of the STOP-Bang questionnaire were 0.784,0.711,0.694 and the differences were statistically significant(P<0.001).When AHI is 5 events/h,15 events/h and 30 events/h as the critical points,the area under the NOSAS score ROC curve is greater than or equal to the STOP-Bang questionnaire score.The NOSAS score has good predictive value.Conclusion As a simple and effective initial screening tool,the NOSAS score can effectively help physicians quickly screen OSAHS patients in physical examination population.

关 键 词：阻塞性睡眠呼吸暂停 OSAHS NOSAS评分 STOP-Bang问卷 

分 类 号：R563[医药卫生—呼吸系统]