Zeng Tingting, Zhang Lisan, Yang Yi, Xie Fei, Zhang Dan, Hu Xingyue
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Department of Neurology, the Central Hospital of Lishui City, Lishui 323700, Zhejiang Province, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2018 May 25;47(2):174-180. doi: 10.3785/j.issn.1008-9292.2018.04.11.
To evaluate the application of various obstructive sleep apnea (OSA) screening scales in patients with acute ischemic stroke.
One hundred and two patients with acute ischemic stroke were enrolled continuously during July 2016 and March 2017 from Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. All patients were assessed by the same physician with various OSA screening scales, including Epworth scale, Berlin questionnaire, STOP-Bang questionnaire, SOS scale, four-variable scale and its modified version. Polysomnography was performed in Sleeping Disorder Center on each patient. According to the apnea-hypopnea index (AHI) acquired from polysomnography, patients were divided into moderate-severe OSA group (AHI ≥ 15, =58) and normal-mild OSA group (AHI<15, =44). The efficiencies of the scales in identification of patients with moderate or severe OSA were analyzed and compared.
The ROC curves showed that the four-variable scale and its modified version had higher area under curve (0.806 and 0.807, both <0.01) for diagnosis of moderate-severe OSA, and the cut-off values for Epworth scale, Berlin questionnaire, STOP-Bang questionnaire, SOS scale, four-variable scale and its modified version were 9, 2, 4, 15, 11, 10, respectively. The sensitivities, specificities, positive and negative predictive values of four-variable scale and its modified version in diagnosis of moderate-severe OSA were higher than those of other scales.
Compared with Epworth scale, Berlin questionnaire, STOP-Bang questionnaire and SOS scale, the four-variable scale and its modified version are more effective in screening of OSA for patients with acute ischemic stroke.
评估各种阻塞性睡眠呼吸暂停(OSA)筛查量表在急性缺血性脑卒中患者中的应用。
2016年7月至2017年3月期间,连续纳入浙江大学医学院附属邵逸夫医院的102例急性缺血性脑卒中患者。所有患者均由同一名医生使用各种OSA筛查量表进行评估,包括爱泼沃斯量表、柏林问卷、STOP-Bang问卷、SOS量表、四变量量表及其修订版。每位患者均在睡眠障碍中心进行多导睡眠监测。根据多导睡眠监测获得的呼吸暂停低通气指数(AHI),将患者分为中重度OSA组(AHI≥15,n = 58)和轻中度OSA组(AHI<15,n = 44)。分析并比较各量表识别中重度OSA患者的效能。
ROC曲线显示,四变量量表及其修订版诊断中重度OSA的曲线下面积较高(分别为0.806和0.807,均P<0.01),爱泼沃斯量表、柏林问卷、STOP-Bang问卷、SOS量表、四变量量表及其修订版的截断值分别为9、2、4、15、11、10。四变量量表及其修订版诊断中重度OSA的灵敏度、特异度、阳性预测值和阴性预测值均高于其他量表。
与爱泼沃斯量表、柏林问卷、STOP-Bang问卷和SOS量表相比,四变量量表及其修订版在急性缺血性脑卒中患者OSA筛查中更有效。