GOAL问卷和Epworth嗜睡量表联合筛查阻塞性睡眠呼吸暂停的效能  

Combined screening efficiency of the GOAL questionnaire and Epworth sleepiness scale in obstructive sleep apnea detection

作　　者：张好杰 王冬皓 张挪富[1] ZHANG Hao-jie;WANG Dong-hao;ZHANG Nuo-fu(Sleep Medicine Center,the First Affiliated Hospital of Guangzhou Medical University(National Center for Respiratory Medicine),Guangzhou 510120,Guangdong,China)

机构地区：[1]广州医科大学附属第一医院(国家呼吸医学中心)睡眠医学中心,广东广州510120 [2]河南大学医学院,河南开封475000

出　　处：《广东医学》2024年第7期897-903,共7页Guangdong Medical Journal

基　　金：南大学医学院硕士(河南开封475000)。

摘　　要：目的检验GOAL问卷和Epworth嗜睡量表(Epworth sleeping scale,ESS)在筛查阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)中联合应用的效能。方法从睡眠医学中心招募2958例参与者,完成夜间多导睡眠图监测和筛查问卷,包括GOAL、ESS、STOP-Bang问卷(SBQ)和NoSAS评分。评估每个量表的敏感度、特异度、阳性预测值、阴性预测值、诊断优势比(diagnostic odds ratio,DOR)和受试者工作特征(ROC)曲线下面积(area under the curve,AUC)。结果GOAL问卷在筛选OSA方面具有更高的敏感度和DOR(敏感度为0.831,DOR为3.72),优于STOP-Bang问卷和NoSAS评分。当GOAL问卷和ESS量表相结合时,特异度和DOR分别显著上升至0.894和4.22。GOAL问卷得分为3且ESS量表≥11分的参与者极有可能患有OSA,概率为0.96。结论GOAL问卷和ESS量表相结合具有优秀的诊断能力,可有效筛查OSA。对疑似OSA患者进行GOAL问卷后的第二阶段进行ESS量表筛查,可以提高预测准确性和早期诊断。Objective To evaluate the effectiveness of combining the GOAL questionnaire and Epworth sleepiness scale(ESS)for screening obstructive sleep apnea(OSA).Methods A total of 2,958 participants were recruited from the Sleep Medicine Center and underwent overnight polysomnography and screening questionnaires including GOAL,ESS,STOP-Bang questionnaire(SBQ),and NoSAS score.Sensitivity,specificity,positive predictive value,negative predictive value,diagnostic odds ratio(DOR),and area under the curve(AUC)were assessed for each tool.Results The GOAL questionnaire demonstrated higher sensitivity and DOR for OSA screening(sensitivity=0.831;DOR=3.72)compared to the STOP-Bang questionnaire and NoSAS score.When the GOAL questionnaire was combined with the ESS,specificity and DOR significantly increased to 0.894 and 4.22,respectively.Participants with a GOAL score of 3 and ESS score≥11 had a high likelihood(probability=0.96)of OSA.Conclusion The combination of the GOAL questionnaire and ESS exhibits excellent diagnostic capabilities and effectively screens for OSA.Sequential screening with the GOAL questionnaire followed by ESS enhances predictive accuracy and facilitates early diagnosis in suspected OSA patients.

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

分 类 号：R563.9[医药卫生—呼吸系统] Q428[医药卫生—内科学]