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[不同体重指数临界值的柏林问卷在阻塞性睡眠呼吸暂停患者筛查中的准确性]

[Accuracy of Berlin questionnaire with different body mass index cutoff values in the screening of patients with obstructive sleep apnea].

作者信息

Li Z, Tang X D

机构信息

Psychosomatic Medicine Center, Sichuan Provincial People's Hospital, Chengdu 610072, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Mar 28;97(12):911-914. doi: 10.3760/cma.j.issn.0376-2491.2017.12.007.

Abstract

To evaluate the accuracy of Berlin questionnaire in the screening of patients with obstructive sleep apnea (OSA), after using different body mass index (BMI) cutoff values. The data were collected from September, 2011 to May, 2012 at the Sleep Medicine Center of West China Hospital, Sichuan University (Chengdu, China). A total of 350 consecutive patients (302 males and 48 females, 19-68 years old, average (42.9±11.0) years old) with suspected OSA who underwent an overnight polysomnography (PSG) were recruited into this study. Berlin questionnaire was completed. Based on the severity of OSA which were determined by apnea-hypopnea index (AHI), the patients were classified into four groups of primary snoring (<5 events/h), mild (5-<15 events/h), moderate (15-<30 events/h) and severe OSA (≥30 events/h). Sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics curve of Berlin questionnaire with different BMI cutoff values were calculated. In patients with BMI≥30 kg/m(2,) to diagnose mild-moderate-severe (AHI≥5 events/h), moderate-severe (AHI≥15 events/h), and severe (AHI≥30 events/h) OSA, the sensitivity of Berlin questionnaire were 69.2%, 71.6%, and 76.6%; the negative predictive values were 15.7%, 33.0%, and 56.5%, respectively. In patients with BMI≥24 kg/m(2,) questionnaire had the highest sensitivity (94.3%, 94.8%, and 96.7%, respectively) and negative predictive values (28.0%, 44.0%, and 72.0%, respectively). When BMI cutoff values gradually declines, the sensitivity and negative predictive values of Berlin questionnaire increase, but the specificity and positive predictive values decline. The accuracy of Berlin questionnaire possibly is related to BMI cutoff values.

摘要

为评估采用不同体重指数(BMI)临界值后,柏林问卷在阻塞性睡眠呼吸暂停(OSA)患者筛查中的准确性。数据于2011年9月至2012年5月在四川大学华西医院睡眠医学中心(中国成都)收集。共纳入350例连续的疑似OSA患者(302例男性和48例女性,年龄19 - 68岁,平均(42.9±11.0)岁),这些患者均接受了整夜多导睡眠图(PSG)检查。完成柏林问卷。根据呼吸暂停低通气指数(AHI)确定的OSA严重程度,将患者分为原发性打鼾(<5次/小时)、轻度(5 - <15次/小时)、中度(15 - <30次/小时)和重度OSA(≥30次/小时)四组。计算不同BMI临界值下柏林问卷的灵敏度、特异度、阳性预测值、阴性预测值以及受试者工作特征曲线下面积。在BMI≥30 kg/m²的患者中,诊断轻度 - 中度 - 重度(AHI≥5次/小时)、中度 - 重度(AHI≥15次/小时)和重度(AHI≥30次/小时)OSA时,柏林问卷的灵敏度分别为69.2%、71.6%和76.6%;阴性预测值分别为15.7%、33.0%和56.5%。在BMI≥24 kg/m²的患者中,问卷具有最高的灵敏度(分别为94.3%、94.8%和96.7%)和阴性预测值(分别为28.0%、44.0%和72.0%)。当BMI临界值逐渐降低时,柏林问卷的灵敏度和阴性预测值升高,但特异度和阳性预测值降低。柏林问卷的准确性可能与BMI临界值有关。

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