临床评分法:一种简易判断阻塞性睡眠呼吸暂停综合征病情的方法

目的 探索一种判断阻塞性睡眠呼吸暂停综合征(OSAHS)病情的临床评分法.方法 对158例OSAHS患者的习惯性打鼾、睡眠时憋气、白天嗜睡、肥胖、高血压5项临床表现进行评分,探讨用临床评分法判断OSAHS病情的价值.结果 两位医师的总评分结果分别为(7.94±3.22)、(7.62±3.08)分,两者呈高度正相关(r=0.97,P=0.00);轻度、中度和重度OSAHS患者分别为43、47、68例,评分结果分别为(5.53±2.25)、(7.66±2.05)、(9.29±2.27)分,彼此之间差异均有统计学意义(P=0.00),总评分结果为(7.78±2.68)分,与呼吸暂停低通气指数(37.15±19.53)也呈显著正相关(r=0.70,P=0.00);ROC分析表明以临床评分最优截断点7分为界,区分轻度与中重度OSAHS的敏感度为83.5%,特异度为74.4%,准确度为80.4%.结论 临床评分法判断OSAHS患者病情具有较好的可靠性、有效性和较高的准确性.

Abstract：

Objective To develop a score based on clinical symptoms and signs for evaluating the severity of obstructive sleep apnea syndrome (OSAHS). Methods A total of 158 OSAHS patients were enrolled. Five clinical features,including habitual snore,sleep apnea,daytime sleepiness,obesity and hypertension were used to arrive at a clinical score and its value to evaluate severity of OSAHS was determined. Results The clinical score of the two assessors was (7.94 ± 3.22) and (7.62 ± 3.08) scores respectively and a highly significant positive correlation was obtained (r = 0.97,P= 0.00). The clinical score of mild (43 cases ), moderate(47 cases ) and severe OSAHS ( 68 cases ) was ( 5.53 ± 2.25 ), ( 7.66 ± 2.05 ) and (9.29 ± 2.27) scores respectively,and there was significant difference among three groups (P = 0.00). The general clinical score of the two assessors was (7.78 ± 2.68) scores,the apnea-hypopnea index was 37.15 ±19.53,and there was a significant positive correlation between them (r = 0.70,P= 0.00). By analysis of ROC curves, the cut-off values of clinical score for differentiating moderate-severe OSAHS from mild OSAHS was 7 scores, and the sensitivity, specificity and accuracy was 83.5%, 74.4% and 80.4% respectively. Conclusion Clinical score,with good reliability,validity and high sccuracy,is a simple method to evaluate severity of OSAHS.

Clinical score:a simple tool to evaluate the severity of obstructive sleep apnea syndrome

Objective To develop a score based on clinical symptoms and signs for evaluating the severity of obstructive sleep apnea syndrome (OSAHS). Methods A total of 158 OSAHS patients were enrolled. Five clinical features,including habitual snore,sleep apnea,daytime sleepiness,obesity and hypertension were used to arrive at a clinical score and its value to evaluate severity of OSAHS was determined. Results The clinical score of the two assessors was (7.94 ± 3.22) and (7.62 ± 3.08) scores respectively and a highly significant positive correlation was obtained (r = 0.97,P= 0.00). The clinical score of mild (43 cases ), moderate(47 cases ) and severe OSAHS ( 68 cases ) was ( 5.53 ± 2.25 ), ( 7.66 ± 2.05 ) and (9.29 ± 2.27) scores respectively,and there was significant difference among three groups (P = 0.00). The general clinical score of the two assessors was (7.78 ± 2.68) scores,the apnea-hypopnea index was 37.15 ±19.53,and there was a significant positive correlation between them (r = 0.70,P= 0.00). By analysis of ROC curves, the cut-off values of clinical score for differentiating moderate-severe OSAHS from mild OSAHS was 7 scores, and the sensitivity, specificity and accuracy was 83.5%, 74.4% and 80.4% respectively. Conclusion Clinical score,with good reliability,validity and high sccuracy,is a simple method to evaluate severity of OSAHS.