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[STOP-Bang问卷在阻塞性睡眠呼吸暂停患者筛查中的准确性]

[The accuracy of STOP-Bang questionnaire in the screening of patients with obstructive sleep apnea].

作者信息

Li Z, Tang X D

机构信息

Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China, is working in the Department of Psychiatry, Panzhihua Shengtai Rehabilitation Hospital, Panzhihua 617000, China.

Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Apr 14;100(14):1057-1062. doi: 10.3760/cma.j.cn112137-20191031-02365.

Abstract

To evaluate the accuracy of STOP-Bang (SBQ) questionnaire in the screening of patients with obstructive sleep apnea (OSA). The data were collected from September, 2011 to May, 2012 at the Sleep Medicine Center of West China Hospital, Sichuan University. 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. SBQ 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 (5-14 events/h), moderate (15-29 events/h) and severe OSA (≥30 events/h). To evaluate the accuracy of SBQ, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics curve of SBQ questionnaire were calculated. Of the subjects, 322 (92.0%) were classified as high risk based on the questionnaire. With mild+moderate+severe OSA (AHI≥5 events/h), moderate+severe OSA (AHI≥15 events/h), and severe OSA as cutoffs, the sensitivity of SBQ questionnaire were 94.0%, 94.1%, and 95.3%; the specificity were 25.7%, 15.2%, and 13.2%; the positive predictive values were 91.9%, 79.2%, and 63.4%; the negative predictive values were 32.1%, 42.9%, and 64.3%, respectively. When variable BMI and age cutoffs (BMI≥24 kg/m(2) and age>42 years old), the questionnaire had the highest sensitivity (98.4%, 98.2%, and 99.5%, respectively) and the lowest specificity (8.6%, 3.8%, and 5.2%, respectively). When BMI and/or age cutoff values gradually decline, the sensitivity of SBQ questionnaire are increased, but the specificity and positive predictive values are declined. Lowering BMI and/or age cutoffs possibly does not improve questionnaire accuracy.

摘要

评估STOP - Bang(SBQ)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收集。共有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)接受了整夜多导睡眠图(PSG)检查并纳入本研究。完成了SBQ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 - 14次/小时)、中度(15 - 29次/小时)和重度OSA(≥30次/小时)四组。为评估SBQ的准确性,计算了SBQ问卷的敏感性、特异性、阳性预测值、阴性预测值以及受试者操作特征曲线下面积。在这些受试者中,根据问卷有322例(92.0%)被分类为高风险。以轻度+中度+重度OSA(AHI≥5次/小时)、中度+重度OSA(AHI≥15次/小时)和重度OSA为截断值时,SBQ问卷的敏感性分别为94.0%、94.1%和95.3%;特异性分别为25.7%、15.2%和13.2%;阳性预测值分别为91.9%、79.2%和63.4%;阴性预测值分别为32.1%、42.9%和64.3%。当采用可变的BMI和年龄截断值(BMI≥24 kg/m²且年龄>42岁)时,问卷具有最高的敏感性(分别为98.4%、98.2%和99.5%)和最低的特异性(分别为8.6%、3.8%和5.2%)。当BMI和/或年龄截断值逐渐降低时,SBQ问卷的敏感性增加,但特异性和阳性预测值降低。降低BMI和/或年龄截断值可能不会提高问卷的准确性。

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