体重指数35千克/平方米并不适用于所有人：一份针对中国人群睡眠呼吸暂停筛查的改良版STOP-Bang问卷。
BMI 35 kg/m does not fit everyone: a modified STOP-Bang questionnaire for sleep apnea screening in the Chinese population.
作者信息
Xia Ming, Liu Su, Ji Ningning, Xu Jianguo, Zhou Zhiqiang, Tong Jianhua, Zhang Yongmei
机构信息
Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, 209 Tongshan Road, Xuzhou, 221002, China.
Department of Anesthesiology, Affiliated Hospital, Xuzhou Medical University, Xuzhou, China.
出版信息
Sleep Breath. 2018 Dec;22(4):1075-1082. doi: 10.1007/s11325-017-1610-6. Epub 2018 Jan 10.
PURPOSE
The STOP-Bang questionnaire is the most widely used to detect surgical patients at high risk of obstructive sleep apnea (OSA). However, the body mass index (BMI) cutoff value in the original STOP-Bang questionnaire is 35 kg/m; the BMI in the Chinese population is lower than that. We aimed to establish a more appropriate BMI cutoff value in the STOP-Bang questionnaire for Chinese patients.
METHODS
A total of 790 consecutive patients scheduled to undergo surgery at our hospital were included in this prospective study. All patients were asked to complete the STOP-Bang questionnaire and undergo a 7-h overnight polysomnography (PSG). The ability of STOP-Bang questionnaire to detect moderate to severe OSA (AHI ≥ 15 events/h) was assessed.
RESULTS
When the BMI cutoff value was set at 28 kg/m, the questionnaire had the highest Youden index, although no significant differences were found in the sensitivity of the test compared with the original BMI cutoff in total and in male patients. In females, changing the BMI cutoff value from 35 to 28 kg/m resulted in the sensitivity of the test significantly increasing from 79.2% (74.9-83.5) to 89.3% (84.4-94.1), while the decrease in specificity was minor (from 43.6% [41.2-46.0] to 38.2% [36.1-40.3]), and the Youden index was highest (0.27) at this cutoff value. When the STOP-Bang questionnaire score was 4, the highest Youden index was obtained.
CONCLUSIONS
We recommend using a BMI cutoff value (28 kg/m), and a STOP-Bang score ≥ 4 allows the anesthetist to identify patients with high risk of OSA.
目的
STOP-Bang问卷是检测阻塞性睡眠呼吸暂停（OSA）高危手术患者最常用的工具。然而，原始STOP-Bang问卷中的体重指数（BMI）临界值为35kg/m²；中国人群的BMI低于该值。我们旨在为中国患者在STOP-Bang问卷中建立更合适的BMI临界值。
方法
本前瞻性研究纳入了我院790例计划接受手术的连续患者。所有患者均被要求完成STOP-Bang问卷，并接受7小时的夜间多导睡眠图（PSG）检查。评估STOP-Bang问卷检测中度至重度OSA（呼吸暂停低通气指数[AHI]≥15次/小时）的能力。
结果
当BMI临界值设定为28kg/m²时，该问卷的约登指数最高，尽管在总体和男性患者中，与原始BMI临界值相比，检测敏感性无显著差异。在女性中，将BMI临界值从35kg/m²改为28kg/m²，检测敏感性从79.2%（74.9-83.5）显著提高到89.3%（84.4-94.1），而特异性降低较小（从43.6%[41.2-46.0]降至38.2%[36.1-40.3]），且在此临界值时约登指数最高（0.27）。当STOP-Bang问卷评分为4时，获得最高约登指数。
结论
我们建议使用BMI临界值（28kg/m²），且STOP-Bang评分≥4可使麻醉医生识别出OSA高危患者。
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