STOP-Bang问卷在高血压患者中筛查阻塞性睡眠呼吸暂停低通气综合征的价值
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江苏省重点研发计划(社会发展)项目(BE2016710)


Value of STOP-Bang questionnaire in screening obstructive sleep apnea hypopnea syndrome in hypertensive patients
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    摘要:

    目的 评价STOP-Bang问卷在高血压患者中筛查阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的价值。方法 选取2014年6月至2015年12月220例因高血压病就诊于扬州市第一人民医院心血管内科、疑诊OSAHS来呼吸科行多导睡眠监测(PSG)的患者,行STOP-Bang问卷评分,并根据PSG监测结果将患者分为非OSAHS组及轻、中、重度OSAHS组,分析问卷结果与PSG结果的相关性,了解STOP-Bang问卷筛查OSAHS的灵敏度、特异度、阳性预测值及阴性预测值,绘制受试者工作特征(ROC)曲线。结果 4组患者STOP-Bang评分随严重程度增加而逐渐增高(分别为2.58±0.85,3.28±1.09,4.09±1.13,4.83±1.09),非OSAHS组与其他各组的STOP-Bang评分结果差异均有统计学意义(P<0.001)。以3分为截断点诊断呼吸暂停低通气指数(AHI)≥5,>15,>30的灵敏度分别为88.58%,95.52%和98.96%。阴性预测值为47.5%,85.0%和97.5%。诊断OSAHS与金标准的符合率达82.73%。当AHI≥5次/h时,ROC曲线下面积为0.844。结论 STOP-Bang问卷可用于筛查高血压患者是否合并OSAHS,其具有较好的可行性和准确性。

    Abstract:

    Objective To evaluate the predictive value of the STOP-Bang questionnaire in screening obstructive sleep apnea hypopnea syndrome (OSAHS) in the patients with hypertension. Methods A total of 220 patients admitted in the Department of Cardiology of the First People’s Hospital of Yangzhou from June 2014 to December 2015 due to hypertension but with suspected OSAHS were enrolled in this study. All the subjects were surveyed with STOP-Bang questionnaire, and given polysomnography (PSG). According to the results of PSG, they were divided into non-OSAHS, and mild, moderate and severe OSAHS groups. The results of STOP-Bang score and PSG were compared and analyzed for the sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics (ROC) curve of the questionnaire. Results The STOP-Bang questionnaire scores were elevated with the increased severity of OSHAS (2.58±0.85, 3.28±1.09, 4.09±1.13 and 4.83±1.09). Significant difference were found in the STOP-Bang scores between the non-OSAHS group and the other 3 OSAHS groups respectively (P<0.001). The sensitivities of STOP-Bang scoring model for apnea hypopnea index (AHI)≥5, >15, >30 were 88.58%, 95.52% and 98.96% respectively, and the negative predictive values were 47.5%, 85.0% and 97.5% respectively. The coincidence rate of STOP-Bang scoring model was 82.73% when compared with gold standard to diagnose OSAHS. The area under the ROC curve at AHI≥5 was 0.844. Conclusion The STOP-Bang questionnaire is suitable to screen OSAHS among hypertensive patients, with sound feasibility and accuracy.

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胡 涛,顾 扬,徐宪韬,欧阳晓平,徐 艳,胡 峰,吴 峰*,张希龙. STOP-Bang问卷在高血压患者中筛查阻塞性睡眠呼吸暂停低通气综合征的价值[J].中华老年多器官疾病杂志,2016,15(11):823~827

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  • 收稿日期:2016-05-05
  • 最后修改日期:2016-06-17
  • 录用日期:2016-06-17
  • 在线发布日期: 2016-11-23
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