Castorena-Maldonado Armando, Espinosa-Morett Laura, Arredondo Del Bosque Fernando, Carrillo-Alduenda José Luis, Torre-Bouscoulet Luis, Vázquez-García Juan Carlos, Pérez-Padilla José Rogelio
Sleep Disorders Clinic, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, México, D.F., México.
Department of Otorhinolaryngology, Head and Neck Surgery, Instituto Nacional de Rehabilitación, México, D.F., México.
Rev Invest Clin. 2015 Jul-Aug;67(4):258-65.
Obstructive sleep apnea syndrome is a major public health problem. The morphometric model and the Sleep Apnea Clinical Score are widely used to evaluate adults; however, neither of these tools has been validated in a Mexican population.
To determine the diagnostic value of the morphometric model and the Sleep Apnea Clinical Score and compare them with conventional clinical instruments.
A total of 97 individuals were recruited prospectively. Initial screening excluded 36, of whom nine were subjects without apnea; the remaining 52 were consecutive patients with obstructive sleep apnea syndrome diagnosed by nocturnal polysomnography. Diagnostic values of each test were calculated.
Obstructive sleep apnea syndrome patients had significantly higher scores with both instruments than controls: morphometric model: 61.3 (95% CI: 45.5-75.3) vs. 41.0 (95% CI: 35.6-45.6); Sleep Apnea Clinical Score: 45.3 (95% CI: 39.5-40.3) vs. 36 (95% CI: 34.0-36.5), respectively. For severe cases, the best cutoff point for morphometric model was 46, with a sensitivity of 81% (95% CI: 62.5-92.6) and specificity of 46.7% (95% CI: 66.4-100), while for Sleep Apnea Clinical Score it was > 48, with a sensitivity of 61% (95% CI: 46.1-74.2) and specificity of 80.4% (95% CI: 66-90.6).
A morphometric model value of ≥ 46 or an adjusted neck circumference (Sleep Apnea Clinical Score) > 48 were adequate for diagnosing obstructive sleep apnea syndrome.
阻塞性睡眠呼吸暂停综合征是一个主要的公共卫生问题。形态测量模型和睡眠呼吸暂停临床评分被广泛用于评估成年人；然而，这些工具在墨西哥人群中均未得到验证。
确定形态测量模型和睡眠呼吸暂停临床评分的诊断价值，并将它们与传统临床工具进行比较。
前瞻性招募了97名个体。初步筛查排除了36人，其中9人无呼吸暂停；其余52人是通过夜间多导睡眠图诊断为阻塞性睡眠呼吸暂停综合征的连续患者。计算了每项测试的诊断价值。
阻塞性睡眠呼吸暂停综合征患者在这两种工具上的得分均显著高于对照组：形态测量模型：61.3（95%可信区间：45.5 - 75.3）对41.0（95%可信区间：35.6 - 45.6）；睡眠呼吸暂停临床评分：45.3（95%可信区间：39.5 - 40.3）对36（95%可信区间：34.0 - 36.5）。对于重症病例，形态测量模型的最佳截断点为46，敏感性为81%（95%可信区间：62.5 - 92.6），特异性为46.7%（95%可信区间：66.4 - 100），而睡眠呼吸暂停临床评分为>48，敏感性为61%（95%可信区间：46.1 - 74.2），特异性为80.4%（95%可信区间：66 - 90.6）。
形态测量模型值≥46或调整后的颈围（睡眠呼吸暂停临床评分）>48足以诊断阻塞性睡眠呼吸暂停综合征。
