升主动脉直径测量联合NoSAS问卷在体检人群中筛查OSA的价值  

The Value of Ascending Aortic Diameter Measurement Combined with NoSAS Questionnaire in Screening OSA in Physical Examination Population

作　　者：谢港 万玉峰[1] XIE Gang;WAN Yu-feng(Department of Otorhinolaryngology Head and Neck Surgery,Chaohu Hospital Affiliated to Anhui Medical University,Hefei 238000,Anhui,China)

机构地区：[1]安徽医科大学附属巢湖医院耳鼻咽喉头颈外科,安徽合肥238000

出　　处：《医学信息》2022年第24期74-78,共5页Journal of Medical Information

基　　金：2019年度安徽省高校自然科学基金项目(编号:KJ2019A0260);2020年安徽医科大学校科研基金项目(编号:2020xkj220)。

摘　　要：目的分析低剂量胸部CT上测量升主动脉直径联合NoSAS问卷在体检人群中筛查OSA的应用价值。方法选择2021年12月-2022年7月在安徽医科大学附属巢湖医院健康管理中心以睡眠打鼾行多导睡眠图(PSG)监测者453例作为研究对象,根据呼吸暂停低通气指数(AHI)分为正常组(AHI<5次/h)组107例和OSA组(AHI≥5次/h)346例,而OSA组根据严重程度分为轻度组(AHI为5~15次/h)108例、中度组(AHI为16~30次/h)112例、重度组(AHI>30次/h)126例。所有患者均行低剂量胸部CT扫描,并填写NoSAS问卷,测量升主动脉直径(AAD)。比较各组一般资料,并绘制受试者工作特征(ROC)曲线分析NoSAS问卷联合AAD测量与单一NoSAS问卷对OSA的筛查价值。结果正常组与轻、中、重度组年龄、性别比较,差异无统计学意义(P>0.05);四组BMI、吸烟史、颈围、LSpO2、NoSAS评分、AAD比较,差异有统计学意义(P<0.05)。以AHI≥5、15、30次/h为OSA诊断标准,NoSAS问卷敏感度和特异性分别为0.882和0.664、0.906和0.592、0.806和0.511,而NoSAS问卷联合AAD测量敏感度和特异性分别为0.896和0.682、0.926和0.652、0.857和0.678。结论以AHI≥5、15、30次/h作为诊断OSA的标准,NoSAS问卷联合AAD测量的AUC、灵敏度、特异度都较单一NoSAS问卷明显提升,可应用于体检人群OSA的临床初步筛查,具有较好的应用价值。Objective To analyze the application value of measuring the diameter of the ascending aorta on low-dose chest CT in the physical examination population combined with NoSAS questionnaire in OSA screening.Methods A total of 453 patients who underwent polysomnography(PSG)monitoring for sleep snoring in the Health Management Center of Chaohu Hospital Affiliated to Anhui Medical University from December 2021to July 2022 were selected as the study subjects.According to the apnea hypopnea index(AHI),126 cases were divided into normal group(AHI 30times/h)and OSA group(AHI≥5 times/h)346 cases,and OSA group was divided into mild group(AHI 5-15 times/h)108 cases,moderate group(AHI 16-30 times/h)112 cases,severe group(AHI>30 times times/h)126 cases according to the severity.All patients underwent low-dose chest CT scan and filled in the NoSAS questionnaire to measure the ascending aortic diameter(AAD).The general data of each group were compared,and the receiver operating characteristic(ROC)curve was drawn to analyze the screening value of NoSAS questionnaire combined with AAD measurement and single NoSAS questionnaire for OSA.Results There was no significant difference in age and sex between normal group and mild,moderate and severe group(P>0.05),while there were significant differences in BMI,smoking history,neck circumference,LSpO2,NoSAS score and AAD among the four groups(P<0.05).Taking AHI≥5,15 and 30 times/h as the critical points,the sensitivity and specificity of NoSAS score were 0.882,0.664,0.906 and 0.592,0.806,0.511;the sensitivity and specificity of NoSAS score combined with AAD measurement were 0.896,0.682,0.926 and 0.652,0.857,0.678,respectively.Conclusion With AHI≥5,15,30 times/h as the standard for the diagnosis of OSA,the AUC,sensitivity and specificity of NoSAS questionnaire combined with AAD are significantly higher than those of single NoSAS questionnaire.It can be applied to the clinical screening of OSA in physical examination population and has good application value.

关 键 词：阻塞性睡眠呼吸暂停 NoSAS问卷 低剂量胸部CT 升主动脉直径 健康体检 

分 类 号：R563.8[医药卫生—呼吸系统]