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[睡眠内镜检查在阻塞性睡眠呼吸暂停低通气综合征患者阻塞部位诊断中的临床价值:一项系统评价和Meta分析]

[The clinical value of sleep endoscopy in the diagnosis of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome: a systematic review and Meta-analysis].

作者信息

Liao Q Y, Lin X, Ye S N

机构信息

Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China.

Department of Otolaryngology, Fuzhou Children's Hospital of Fujian Province.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Oct 20;31(20):1548-1553. doi: 10.13201/j.issn.1001-1781.2017.20.002.

Abstract

To investigate the clinical value of video laryngoscope in localization diagnosis of upper airway obstruction in OSAHS during drug-induced sleep.We searched the MEDLINE (PubMed), EMBASE, CCTR (The Cochrane Controlled Clinical Trials Register Database), CNKI, WAN FANG databases for randomized, blinded studies according Cochrane systematic review. We chose articles published between 1975 and 2016 about the value of sleep endoscopy in localization diagnosis of upper airway obstruction in OSAHS. All the data were analyzed by the software of the Meta-Disc 1.4.Seven qualitative studies and three quantitative studies were included.A total of three studies with 175 patients met the inclusion criteria for Meta-analysis. Meta-analysis results showed that the merger sensitivity degrees, specific degrees, diagnostic odds ratio, positive likelihood ratio, negative likelihood ratio and 95% were 1.0(0.96-1.0),0.71(0.59-0.81),212.47(36.07-1 251.56),4.40(1.28-15.16),and 0.02(0-0.11) respectively. The SROC area under the concentration-time curve (AUC) was 0.991 0.Because of its high accuracy, sleep endoscopy can be used as an important auxiliary examination and the sensitive indexes for the surgery procedures and prognosis treatment plan for OSAHS. But more cohort studies are needed for the verification.

摘要

为探讨视频喉镜在药物诱导睡眠状态下对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)上气道梗阻定位诊断中的临床价值。我们按照Cochrane系统评价方法,检索MEDLINE(PubMed)、EMBASE、CCTR(Cochrane对照临床试验注册数据库)、中国知网、万方数据库,查找随机、盲法研究。选取1975年至2016年发表的关于睡眠内镜在OSAHS上气道梗阻定位诊断价值的文章。所有数据采用Meta-Disc 1.4软件进行分析。纳入7项定性研究和3项定量研究。共有3项研究175例患者符合Meta分析纳入标准。Meta分析结果显示,合并敏感度、特异度、诊断比值比、阳性似然比、阴性似然比及95%CI分别为1.0(0.96 - 1.0)、0.71(0.59 - 0.81)、212.47(36.07 - 1251.56)、4.40(1.28 - 15.16)和0.02(0 - 0.11)。浓度-时间曲线下面积(AUC)为0.991 0。睡眠内镜因其较高的准确性,可作为OSAHS手术及预后治疗方案的重要辅助检查及敏感指标。但尚需更多队列研究进行验证。

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