NoSAS评分、STOP-Bang问卷和Epworth嗜睡量表对不同年龄OSA患者的筛查价值  

NoSAS score,STOP Bang questionnaire and Epworth sleepiness scale in screening for OSA patients of different ages

作　　者：许绍蓉 彭程 王彦[1] 赵丹 王建青[1] XU Shao-rong;PENG Cheng;WANG Yan;ZHAO Dan;WANG Jian-qing(Department of Respiratory and Critical Care Medicine,Tianjin Medical University General Hospital,Tianjin,300052,China)

机构地区：[1]天津医科大学总医院呼吸与危重症医学科,天津300052

出　　处：《中国临床研究》2023年第1期40-44,共5页Chinese Journal of Clinical Research

摘　　要：目的比较对不同年龄层阻塞性睡眠呼吸暂停(OSA)患者采用NoSAS评分、STOP-Bang问卷(SBQ)、Epworth嗜睡量表(ESS)筛查的实施和价值。方法回顾性分析2017年1月至2021年12月就诊于天津医科大学总医院睡眠中心进行整夜多导睡眠监测(PSG)的打鼾患者1954例的临床资料。将1954例分为四个年龄段组:少年组41例,青年组818例,中年组925例,老年组170例。根据呼吸暂停低通气指数(AHI),将AHI 5~15、>15~30、>30次/h分别判定为OSA轻度、中度和重度。收集患者的症状及人口学资料,计算NoSAS、ESS和SBQ得分,绘制受试者工作特征(ROC)曲线,比较3个量表的敏感度、特异度、阳性预测值和阴性预测值。结果少年组中,在AHI>15、>30次/h时,NoSAS的AUC分别为0.780和0.922,均明显高于SBQ和ESS,对诊断中度和重度OSA有中度以上预测价值。青年组中,在AHI≥5、>15和>30次/h时,NoSAS(AUC分别为0.837、0.786、0.762)和SBQ(AUC分别为0.843、0.786、0.775),对诊断OSA及其严重程度均有中度预测价值。中年和老年组中,在AHI≥5次/h时,NoSAS的AUC分别为0.761、0.800,对诊断OSA的预测价值最高;AHI>15次/h时,SBQ的AUC分别为0.706、0.722,对诊断中重度OSA预测价值最高。以SBQ≥3为判定分界分别预测四个年龄段OSA患者时,其敏感度和阴性预测值大部高于NoSAS和ESS,但特异度大部呈ESS>NoSAS>SBQ。结论在少年人群中,NoSAS适用于筛查中度和重度OSA患者。在青年人群中,SBQ和NoSAS筛查OSA及其严重程度的效果均较好,且SBQ更敏感。在中年和老年人群中,NoSAS筛查OSA的能力较好,但SBQ筛查中重度OSA效果更显著。临床应根据患者的年龄分层选择合适的量表作为OSA的筛查工具,以便更精准地筛查出OSA高风险人群。Objective To compare the predictive value of NoSAS score,STOP-Bang Questionnaire(SBQ)and Epworth sleepiness scale(ESS)in the screening of different ages patients with obstructive sleep apnea(OSA).Methods A retrospective analysis of the clinical data of 1954 snorers who went to the sleep center of Tianjin Medical University General Hospital for overnight polysomnography(PSG)monitoring from January 2017 to December 2021.According to age,there were 41 cases in juvenile group,818 cases in youth group,925 cases in middle-aged group and 170 cases in elderly group.According to the apnea hypopnea index(AHI),5~15,>15~30 and>30 times/h of AHI were determined as mild,moderate and severe OSA respectively.After calculating NoSAS,ESS and SBQ scores and drawing the ROC curve of the subjects,the sensitivity,specificity,positive predictive value and negative predictive value were analyzed and compared among NoSAS,ESS and SBQ scores.Results When AHI>15 and>30 times/h,the AUCs of NoSAS(0.780,0.922,respectively)in juvenile group were significantly higher than those of SBQ and ESS,with more than moderate predictive value for the diagnosis of moderate-to-severe OSA.In youth group,when AHI≥5,>15 and>30 times/h,AUSs of NoSAS(being 0.837,0.786 and 0.762,respectively)and SBQ(being 0.843,0.786 and 0.775,respectively)had moderate predictive value for the diagnosis of OSA and its severity.In middle-aged and elderly group,when AHI≥5 times/h,NoSAS had the highest predictive value,with an AUC value of 0.761 and 0.800;and as AHI>15 times/h,AUC of SBQ was 0.706 and 0.722,respectively,which had the highest predictive value in the diagnosis of moderate and severe OSA.When SBQ≥3 was used as the cutoff to predict OSA in four different age groups,its sensitivity and negative predictive value were mostly higher than those of NoSAS and ESS,but the specificity of ESS was the highest,followed by NoSAS and SBQ.Conclusion In the adolescent population,NoSAS are suitable for screening patients with moderate and severe OSA.In the young population,SBQ and

关 键 词：阻塞性睡眠呼吸暂停 NoSAS评分 EPWORTH嗜睡量表 STOP-Bang问卷 筛查 年龄 

分 类 号：R56[医药卫生—呼吸系统]