摘要
目的为妊娠可能合并阻塞性睡眠呼吸暂停综合征(OSAHS)的患者提供简便、价廉以及准确的初筛诊断方法。方法对妊娠可能合并OSAHS的打鼾产妇78人应用Epworth嗜睡量表(ESS)进行嗜睡评分(EP),并测量颈围(NC)、体质量指数(BMI)。再行多导睡眠监测(PSG)并根据监测所得的呼吸暂停低通气指数(AHI)和最低血氧饱和度(LSaO2)把患者分为鼾症组和OSAHA组(轻、中、重),最后以PSG-AHI为诊断OSAHS的金标准,并分析ESS和PSG-AHI的相关性和绘制受试者工作特性(ROC)曲线。结果各组指标(NC、BMI、EP、AHI、LSaO2)间的比较有显著性差异(P<0.05);EP、PSG监测结果均与AHI具有显著相关(P=0.000)且关系较为密切(r=0.759),并较其他监测指标NC(r=0.668)、BMI(r=0.663)的相关性更高;EP、NC、BMI三者的ROC曲线下面积分别为0.825、0.772、0.784,显示EP值对妊娠合并OSAHS的诊断价值更大;根据交叉曲线,取EP的最佳工作点=7.5时,具有较高的灵敏度(76.8%)和特异性(68.2%)。结论应用方便、经济的Epworth嗜睡量表对妊娠可能合并OSAHS的患者进行筛查有较好的临床诊断价值,并具有较佳的灵敏度和特异性。
Objective To provide a convenient method for screening obstructive sleep apnea-hypopnea syndrome （OSAHS） in pregnant women. Methods Seventy-eight pregnant women with suspected OSAHS were calculated for the EP index using Epworth sleepiness score （ESS） with also measurement of the neck circumference （NC） and body mass index （BMI）. The apnea/hypopnea index （AHI） was calculated and the lowest SaO2 （LSaO2） measured through a 7-h polysomnography （PSG）. The women were then divided into 4 groups according to the AHI and LSaO2. The ESS was compared with the PSG-AHI and the receiver operating characteristic curve （ROC） was generated. Results All the clinical indexes （NC, BMI, EP, AHI, and LSaO2） showed significant differences between the 4 groups （P〈0.05）. EP and PSG Were found to have greater correlations to AHI （r=0.759, P=-0.000） than NC （r=0.668） and BMI （r=0.663）. The area under the ROC of the EP （0.825） was greater than that of NC （0.772） and BMI （0.784）. The index of EP showed greater clinical diagnostic value of OSAHS in pregnancy. Base on the ROC, EP at the optimal operating point of 7.5 had a sensitivity of 76.8% and specificity of 68.2% for diagnosis of OSAHS in pregnant women. Conclusion The ESS is an economic and convenient method for screening OSAHS in pregnant women with high diagnostic sensitivity and specificity.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第9期1914-1916,共3页
Journal of Southern Medical University
