动脉血碳酸氢盐（HCO）浓度对 STOP-Bang 问卷筛查阻塞性睡眠呼吸暂停准确性的影响。
Effect of arterial blood bicarbonate (HCO) concentration on the accuracy of STOP-Bang questionnaire screening for obstructive sleep apnea.
机构信息
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, No. 81 of Mei Shan Road, Hefei, 230001, Anhui, People's Republic of China.
Department of Respiratory and Critical Care Medicine, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), No. 390 of Huai He Road, Hefei, 230001, Anhui, People's Republic of China.
出版信息
BMC Pulm Med. 2021 Nov 13;21(1):366. doi: 10.1186/s12890-021-01720-2.
BACKGROUND
To evaluate the effect of arterial bicarbonate (HCO) concentration on the accuracy of STOP-Bang questionnaire (SBQ) screening for obstructive sleep apnea (OSA).
METHODS
A total of 144 patients with suspected OSA were included. Polysomnograms (PSG) and blood gas analysis were performed, and the Epworth Sleepiness Scale (ESS), STOP-Bang questionnaire, and Berlin questionnaire were completed. The correlation between the arterial HCO concentration, apnea hypopnea index (AHI), and other related indicators was analyzed. The scoring results of the ESS, SBQ, and Berlin questionnaire were compared with the PSG results, and the sensitivity and specificity were calculated in the form of a four-cell table. The changes in the sensitivity and specificity of OSA screening after SBQ alone and combined with HCO concentration were compared, and ROC curves were drawn.
RESULTS
Arterial HCO concentration was positively correlated with AHI (r = 0.537, P < 0.001). The ratio of HCO concentration ≥ 24.6 mmol/L in the non-OSA group was significantly lower than that in the OSA group (25.0% VS 80.8%, P < 0.001). The sensitivity of the SBQ was higher than that of the ESS (97.5% VS 81.7%, P < 0.001) and the Berlin questionnaire (97.5% VS 79.2%, P < 0.001). There was no statistical significance in the specificity of the three scales (25%, 37.5%, 37.5%). A combined SBQ score ≥ 3 and HCO concentration ≥ 24.6 mmol/L showed increased specificity and decreased sensitivity compared with an SBQ score ≥ 3 alone, with a corresponding AUC of 0.771 (P < 0.01) and 0.613 (P > 0.05), respectively.
CONCLUSION
The sensitivity of the SBQ was better than that of the Berlin questionnaire and ESS. After combining arterial blood HCO concentration, the SBQ questionnaire increased the specificity of OSA prediction and decreased the sensitivity, which improved the accuracy of screening.
背景
评估动脉碳酸氢盐（HCO）浓度对阻塞性睡眠呼吸暂停（OSA）筛查中 STOP-Bang 问卷（SBQ）准确性的影响。
方法
共纳入 144 例疑似 OSA 患者，进行多导睡眠图（PSG）和血气分析，完成 Epworth 嗜睡量表（ESS）、SBQ 和柏林问卷。分析动脉 HCO 浓度与呼吸暂停低通气指数（AHI）及其他相关指标的相关性。比较 ESS、SBQ 和柏林问卷评分结果与 PSG 结果，并以四格表形式计算灵敏度和特异度。比较 SBQ 单独及联合 HCO 浓度后 OSA 筛查的灵敏度和特异度变化，并绘制 ROC 曲线。
结果
动脉 HCO 浓度与 AHI 呈正相关（r=0.537，P<0.001）。非 OSA 组 HCO 浓度≥24.6 mmol/L 的比例明显低于 OSA 组（25.0%比 80.8%，P<0.001）。SBQ 的灵敏度高于 ESS（97.5%比 81.7%，P<0.001）和柏林问卷（97.5%比 79.2%，P<0.001）。三个量表的特异度无统计学差异（25%、37.5%、37.5%）。SBQ 评分≥3 分联合 HCO 浓度≥24.6 mmol/L 与单独 SBQ 评分≥3 分相比，特异性增加，敏感性降低，相应 AUC 分别为 0.771（P<0.01）和 0.613（P>0.05）。
结论
SBQ 的灵敏度优于柏林问卷和 ESS。联合动脉血 HCO 浓度后，SBQ 问卷增加了 OSA 预测的特异性，降低了敏感性，提高了筛查的准确性。
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