Objective: To evaluate the clinical value of three questionnaires [Sleep Apnea Clinical Score (SACS), Berlin Questionnaire (BQ), and Epworth Sleepiness Scale (ESS)] in screening obstructive sleep apnea (OSA) in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 198 patients with COPD were assessed the likelihood of OSA by using the SACS, BQ, ESS, which was confirmed by the overnight polysomnography (PSG). The receiver operating characteristic curve (ROC) and the calculated likelihood ratios were used to compare the values of three scoring systems in predicting OSA in COPD patients. Results: The patients had an average age of (65.5±9.3) years and 92.9% (184 cases) of which were male, 14 cases (7.1%) were female; 27 cases (13.6%) had a high probability of OSA by SACS assessment, 61 cases (30.8%) had a high probability screened by BQ, and 72 (36.4%) had OSA high probability by ESS. The diagnosis of OSA in 75 patients (37.9%) were confirmed by PSG. OSA did not be accurately predicted by ESS screening in patients with COPD, with a ROC curve area under the curve of 0.592 (95% CI: 0.509-0.674, P=0.053). BQ had an area under the ROC curve of 0.706 (95% CI: 0.626-0.779, P<0.001). However, the prediction of SACS was much better, with an area under the ROC curve of 0.810 (95% CI: 0.737-0.871, P<0.001). Conclusion: SACS is superior to BQ and ESS in predicting OSA in this group of patients with COPD.
目的： 评价睡眠呼吸暂停临床评分(SACS)、柏林问卷(BQ)、Epworth嗜睡量表(ESS)对慢性阻塞性肺疾病(简称慢阻肺)患者合并阻塞性睡眠呼吸暂停(OSA)的筛查价值。 方法： 使用SACS、BQ和ESS量表对198例慢阻肺患者进行评估，并完成整夜多导睡眠监测(PSG)。通过受试者工作特征(ROC)曲线比较三种量表在预测慢阻肺合并OSA的价值。 结果： 198例患者中，男184例(92.9%)，女14例(7.1%)，年龄(65.5±9.3)岁。SACS、BQ、ESS三种量表预测OSA的高可能性分别为27例(13.6%)、61例(30.8%)、72例(36.4%)。经PSG，75例(37.9%)慢阻肺患者合并OSA。三种量表预测慢阻肺患者合并OSA的曲线下面积分别为0.810(95% CI: 0.737～0.871，P<0.001)、0.706(95% CI: 0.626～0.779，P<0.001)、0.592(95% CI: 0.509～0.674，P＝0.053)。 结论： 相比于BQ及ESS，SACS对慢阻肺合并OSA有更好的预测价值。.
Keywords: Polysomnography; Pulmonary disease, chronic obstructive; Questionnaires; Sleep apnea, obstructive.