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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
邹外龙,李昱霖,吴晓瑞,闫磊,陈济超.肺功能联合睡眠呼吸暂停临床评分对慢性阻塞性肺疾病重叠阻塞性睡眠呼吸暂停患者的初筛价值[J].中华老年多器官疾病杂志,2021,20(10):760~764
肺功能联合睡眠呼吸暂停临床评分对慢性阻塞性肺疾病重叠阻塞性睡眠呼吸暂停患者的初筛价值
Value of pulmonary function combined with sleep apnea clinical score in preliminary screening for chronic obstructive pulmonary disease overlapping obstructive sleep apnea
投稿时间:2021-02-27  
DOI:10.11915/j.issn.1671-5403.2021.10.158
中文关键词:  睡眠呼吸暂停,阻塞性;肺疾病,慢性阻塞性;重叠综合征;肺功能;睡眠呼吸暂停临床评分
英文关键词:sleep apnea, obstructive; pulmonary disease, chronic obstructive; overlap syndrome; pulmonary function; sleep apnea clinical score This work was supported by the Special Clinical Research Grant of Wu Jieping Medical Foundation
基金项目:吴阶平医学基金会临床科研专项资助基金(320.6750.19089-2)
作者单位E-mail
邹外龙 航天中心医院呼吸与危重症医学科,北京 100049  
李昱霖 航天中心医院呼吸与危重症医学科,北京 100049  
吴晓瑞 航天中心医院呼吸与危重症医学科,北京 100049  
闫磊 航天中心医院呼吸与危重症医学科,北京 100049  
陈济超 航天中心医院呼吸与危重症医学科,北京 100049 chen_htzxyy@sina.com 
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全文下载次数: 20
中文摘要:
      目的 探讨第1秒用力呼气容积占预计值百分比(FEV1%pred)结合睡眠呼吸暂停临床评分(SACS)对慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSA)患者的初筛价值。方法 选取2020年1月至12月于航天中心医院呼吸与危重症医学科住院检查确诊为COPD的299例患者为研究对象,所有患者均完成肺功能FEV1%pred检查以及SACS,行整夜多导睡眠图(PSG)监测。根据睡眠呼吸暂停低通气指数(AHI)将患者分为单纯COPD组和COPD合并OSA(重叠综合征,OVS)组。采用SPSS 23.0软件进行统计分析。根据数据类型,组间比较分别采用独立样本t检验或χ2检验。采用Pearson′s相关系数分析FEV1%pred、SACS与AHI的相关性。采用受试者工作特征(ROC)曲线分析FEV1%pred结合SACS预测COPD患者OVS的价值。 结果 OVS组FEV1%pred [(53.4±15.1)和(43.6±13.9)%;P<0.05]及SACS[(19.1±3.9)和(7.3±2.1)分;P<0.05]显著高于单纯COPD组。相关性分析显示,AHI与FEV1%pred(r=0.631,P<0.05)及SACS(r=0.689,P<0.05)呈正相关。ROC曲线显示,FEV1%pred诊断OVS的最佳截断点为48.3%,灵敏度和特异度分别为81.3%和75.4%;SACS诊断OVS的最佳截断值为16,灵敏度和特异度分别为83.2%和79.3%;将FEV1%pred≥48.3%和SACS≥16分作为联合指标诊断OVS的曲线下面积为0.812(95%CI 0.781~0.903),灵敏度和特异度分别为85.2%和79.5%。 结论 FEV1%pred联合SACS评分对筛查COPD患者OVS具有良好的预测价值。
英文摘要:
      Objective To explore the value of percentage of forced expiratory volume in the predicted value in the first second (FEV1%pred) combined with sleep apnea clinical score (SACS) in primary screening for patients with chronic obstructive pulmonary disease (COPD) complicated with obstructive sleep apnea (OSA). Methods A total of 299 patients diagnosed with COPD in our department from January to December 2020 were selected as the research objects. All patients completed FEV1%pred examination of pulmonary function and SACS evaluation, and were monitored by overnight polysomnography (PSG). According to their sleep apnea hypopnea index (AHI), the patients were divided into simple COPD group and COPD combined with OSA (overlap syndrome, OVS). SPSS statistics 23.0 was used for statistical analysis. According to the data types, independent sample t-test or Chi-square test was adopted for intergroup comparison. Pearson′s correlation coefficient was used to analyze the correlation in FEV1%pred, SACS and AHI. Receiver operating characteristic (ROC) curve was employed to analyze the value of FEV1%pred combined with SACS in prediction of OVS in COPD patients. Results FEV1%pred [(53.4±15.1) vs (43.6±13.9)%, P<0.05] and SACS [(19.1±3.9) vs (7.3±2.1) points, P<0.05] were significantly higher in the OVS group than the COPD group. Correlation analysis showed that AHI was positively correlated with FEV1%pred (r=0.631, P<0.05) and SACS (r=0.689, P<0.05). ROC curve suggested that the best cut-off value of FEV1%pred in the diagnosis of OVS was 48.3%, and the sensitivity and specificity were 81.3% and 75.4%, respectively. The best cut-off value of SACS for the diagnosis of OVS was 16, and the sensitivity and specificity were 83.2% and 79.3%, respectively. Taking FEV1%pred ≥48.3% and SACS ≥16 points as joint indicators, the area under the curve for the diagnosis of OVS was 0.812 (95%CI 0.781-0.903), and the sensitivity and specificity were 85.2% and 79.5%, respectively. Conclusion FEV1%pred combined with SACS has good predictive value in the screening of OVS in COPD patients.
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