摘要
目的分析STOP-Bang问卷在以糖尿病患者为基础的睡眠呼吸障碍疾病(SDB)筛查中的应用价值,并比较STOP-Bang问卷(SBQ)与Epworth嗜睡量表(ESS)、STOP问卷、Berlin问卷的预测价值。方法分析2014年7月-2017年12月在广东医科大学附属第二医院睡眠医学中心连续就诊进行整夜多导睡眠图(PSG)监测的糖尿病患者172例可疑SDB患者资料,包括STOP-Bang问卷、ESS评分、STOP问卷和Berlin问卷的全部项目及患者一般资料。根据呼吸暂停低通气指数(AHI)将患者分为正常组(AHI<5次/h)、轻度SDB组(AHI 5~<15次/h)、中度SDB组(AHI 15~<30次/h)、重度SDB组(AHI≥30次/h)。统计各问卷筛查SDB的敏感性、特异性、阳性预测值、阴性预测值,绘制受试者工作特征(ROC)曲线,比较各问卷筛查SDB的效能。结果以AHI≥5为诊断SDB的标准,STOP-Bang问卷的AUC曲线下面积(AUC)为0.705,Berlin问卷的ROC曲线下面积为(AUC)0.708,STOP问卷为0.714,对于SDB均有较好的预测价值。而ESS评分曲线下面积为0.668预测效能稍差。STOP-Bang问卷预测AHI≥5次/h、AHI≥15次/h、AHI≥30次/h的SDB患者的敏感性和特异度分别0.917和0.225、0.928和0.173、0.934和0.144;STOP问卷预测AHI≥5次/h、AHI≥15次/h、AHI≥30次/h的SDB患者的敏感性和特异度分别0.856和0.425、0.897和0.347、0.885和0.261;Berlin问卷为0.788和0.500、0.835和0.427、0.836和0.342。结论 STOP-Bang问卷、Berlin问卷对SDB均有较好的预测价值。STOP-Bang问卷可作为一种新的简便、有效、实用的SDB的筛查工具应用于临床糖尿病人群快速筛查SDB患者,可有效帮助临床医师快速着手解决糖尿病患者夜间缺氧情况,控制血糖。
Objective To evaluate the clinical value of STOP-Bang questionnaire in screening sleep-disordered breathing（SDB） in patients with diabetes and to compare the predictive value of STOP-Bang questionnaire（SBQ）, Epworth Sleepiness Scale（ESS）, STOP questionnaire and Berlin questionnaire. Methods A total of 172 diabetes patients suspected of SDB that have been consecutively treated at the Sleep Medical Center of the Second Affiliated Hospital of Guangdong Medical University from July 2014 to December 2017 and underwent overnight polysomnography（PSG） were enrolled in this study, and their clinical data were analyzed, including STOP-Bang questionnaire, ESS score, STOP questionnaire and Berlin questionnaire as well as the basic data of patients. Based on the severity of SDB determined by the apnea-hypopnea index（AHI）, the patients were divided into four groups： Normal Group（5 events/h）, Mild SDB Group（5-15 events/h）, Moderate SDB Group（15-30 events/h） and Severe SDB Group（≥30 events/h）. The sensitivity, specificity, positive predictive value and negative predictive value of each questionnaire in screening SDB was statistically analyzed, receiver operating characteristic（ROC） curve was drawn, and the efficacy of four questionnaires in screening SDB was compared. Results If AHI≥5 is used as the criteria for diagnosing SDB, the STOP-Bang questionnaire had an AUC of 0.705, the Berlin questionnaire（AUC=0.708）, and the STOP questionnaire（AUC=0.714）, showing a good predictive value. ESS score had an AUC of 0.668, showing a poorer predictive efficacy. In terms of the sensitivity and specificity in predicting the patients with AHI≥5 events/h, AHI≥15 events/h and AHI≥30 events/h, STOP-Bang questionnaire had the value of 0.917 and 0.0.225, 0.928 and 0.173, and 0.934 and 0.144, respectively; STOP questionnaire had the value of 0.856 and 0.425, 0.897 and 0.347, and 0.885 and 0.261, respectively; and Berlin questionnaire had the value of 0.788 and 0.500, 0.835 and 0.427, and 0
作者
黄蕙莉
刘旺
郭行端
梁金花
叶志东
成俊芬
HUANG Hui-li;LIU Wang;GUO Xing-duan;LIANG Jin-hua;YE Zhi-dong;CHENG Jun-fen(Department of Endocrinology;Department of Respiration,the Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524000,China)
出处
《广东医科大学学报》
2018年第3期267-272,共6页
Journal of Guangdong Medical University
