考虑到年龄、性别和合并症，哪种筛查问卷最适合预测睡眠诊所人群中的阻塞性睡眠呼吸暂停？
Which Screening Questionnaire is Best for Predicting Obstructive Sleep Apnea in the Sleep Clinic Population Considering Age, Gender, and Comorbidities?
作者信息
Oktay Arslan Burcu, Uçar Hoşgör Zeynep Zeren, Orman Mehmet Nurullah
机构信息
Department of Chest Diseases and Sleep Disorders Center University of Healthy Sciences, Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, İzmir, Turkey.
Department of Biostatistics, Ege University School of Medicine, İzmir, Turkey.
出版信息
Turk Thorac J. 2020 Nov;21(6):383-389. doi: 10.5152/TurkThoracJ.2019.19024. Epub 2020 Nov 1.
OBJECTIVE
The purpose of this study was to evaluate the predictive power of the screening questionnaires including Epworth Sleepiness Scale (ESS), Berlin questionnaire (BQ) and STOP-Bang questionnaire (SBQ) to identify the high-risk patients for OSA in a sleep clinic setting considering age, gender and comorbidities.
MATERIAL AND METHODS
1003 patients who admitted to our sleep center with the preliminary diagnosis of OSA between June 2016-May 2018 were included in the study. All patients underwent in-lab polysomnographic examination and filled out ESS, Berlin and STOP-Bang questionnaires. Predictive parameters for each screening questionnaires were calculated.
RESULTS
For apnea-hypopnea index (AHI) ≥5/h, the sensitivity and the specificity of the EES, BQ and SBQ were 50.6%, 89.8%, 97.9% and 56.6%, 27.3%, 16.2% respectively. The STOP-Bang questionnaire had the highest sensitivity in both males and females (99.1%, 94.8% respectively) and in the different age groups (97.3% for ≥45 age-group, 99.2% for ≥65 age-group). In the groups of patients with hypertension, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease and asthma, the sensitivity of the STOP-Bang questionnaire was 99.5%, 100%, 99.5%, 100%, 97.4%, respectively.
CONCLUSION
The STOP-Bang questionnaire had the highest sensitivity for detecting high-risk patients for OSA in a sleep clinic setting. STOP-Bang questionnaire was superior to the Berlin questionnaire and ESS in the different groups of age, gender, and comorbidities. Considering the close relationship between OSA and comorbidities, it is critical to screen patients in terms of OSA in outpatient clinics of internal medicine, cardiology, and chest disease departments. The STOP-Bang questionnaire, with its high sensitivity, may be useful for screening OSA. However, the low specificity should be improved in the questionnaire.
目的
本研究旨在评估包括爱泼沃斯思睡量表（ESS）、柏林问卷（BQ）和STOP-Bang问卷（SBQ）在内的筛查问卷在睡眠诊所环境中，考虑年龄、性别和合并症因素时识别阻塞性睡眠呼吸暂停（OSA）高危患者的预测能力。
材料与方法
纳入2016年6月至2018年5月期间因初步诊断为OSA而入住我们睡眠中心的1003例患者。所有患者均接受了实验室多导睡眠图检查，并填写了ESS、柏林问卷和STOP-Bang问卷。计算了每个筛查问卷的预测参数。
结果
对于呼吸暂停低通气指数（AHI）≥5次/小时，ESS、BQ和SBQ的敏感性和特异性分别为50.6%、89.8%、97.9%和56.6%、27.3%、16.2%。STOP-Bang问卷在男性和女性中（分别为99.1%、94.8%）以及在不同年龄组中（≥45岁年龄组为97.3%，≥65岁年龄组为99.2%）具有最高的敏感性。在高血压、糖尿病、冠状动脉疾病、慢性阻塞性肺疾病和哮喘患者组中，STOP-Bang问卷的敏感性分别为99.5%、100%、99.5%、100%、97.4%。
结论
在睡眠诊所环境中，STOP-Bang问卷在检测OSA高危患者方面具有最高的敏感性。在不同年龄、性别和合并症组中，STOP-Bang问卷优于柏林问卷和ESS。考虑到OSA与合并症之间的密切关系，在内科、心脏病科和胸科门诊对患者进行OSA筛查至关重要。STOP-Bang问卷因其高敏感性可能有助于筛查OSA。然而，该问卷的低特异性应加以改进。
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