CAJ | 학술논문

目的应用受试者工作特征曲线(receiver operating characteristic curve,ROC curve)探讨体质指数(BMI)、颈围、腰围及腰臀比等各种肥胖参数筛查、诊断老年男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的参考切点并比较其价值. 方法分析402例老年男性患者的BMI、颈围、腰围及腰臀比与呼吸暂停低通气指数(apnea-hypopnea index,AHI)间的相关性;用ROC曲线确定BMI、颈围、腰围、腰臀比等肥胖参数筛查、诊断OSAHS的参考切点;用ROC曲线下面积(Area under curve,AUC)判断各肥胖参数的整体准确性. 结果 (1)老年男性BMI、颈围、腰围及腰臀比均与AHI呈正相关,其相关系数分别为0.241、0.201、0.210、0.097,P值分别为0.000、0.000、0.000、0.053;BMI、颈围、腰围及腰臀比ROC曲线下面积分别为:0.61、0.58、0.51、0.45,P值分别为0.001、0.060、0.840、0.250;BMI可用于筛查、诊断老年男性OSAHS;颈围、腰围、腰臀比尚不足以用于筛查、诊断老年男性OSAHS;(2)灵敏度达90%,漏诊率10%时,BMI筛查OSAHS的切点为22.0kg/m~2;(3)特异度达90%,误诊率10%时,BMI确诊OSAHS的切点为29.0 kg/m~2. 结论 BMI≥22.0 kg/m~2可作为筛查老年男性OSAHS的参考标准;BMI≥29.0 kg/m~2可作为诊断老年男性OSAHS的参考标准.
목적 응용수시자공작특정곡선(receiver operating characteristic curve,ROC curve)탐토체질지수(BMI)、경위、요위급요둔비등각충비반삼수사사、진단노년남성조새성수면호흡잠정저통기종합정(OSAHS)적삼고절점병비교기개치. 방법 분석402례노년남성환자적BMI、경위、요위급요둔비여호흡잠정저통기지수(apnea-hypopnea index,AHI)간적상관성;용ROC곡선학정BMI、경위、요위、요둔비등비반삼수사사、진단OSAHS적삼고절점;용ROC곡선하면적(Area under curve,AUC)판단각비반삼수적정체준학성. 결과 (1)노년남성BMI、경위、요위급요둔비균여AHI정정상관,기상관계수분별위0.241、0.201、0.210、0.097,P치분별위0.000、0.000、0.000、0.053;BMI、경위、요위급요둔비ROC곡선하면적분별위:0.61、0.58、0.51、0.45,P치분별위0.001、0.060、0.840、0.250;BMI가용우사사、진단노년남성OSAHS;경위、요위、요둔비상불족이용우사사、진단노년남성OSAHS;(2)령민도체90%,루진솔10%시,BMI사사OSAHS적절점위22.0kg/m~2;(3)특이도체90%,오진솔10%시,BMI학진OSAHS적절점위29.0 kg/m~2. 결론 BMI≥22.0 kg/m~2가작위사사노년남성OSAHS적삼고표준;BMI≥29.0 kg/m~2가작위진단노년남성OSAHS적삼고표준.
Objective To screen and diagnose obstructive sleep apnea-hypopnea syndrome (OSAHS) in elderly males by obesity index using receiver operating characteristic(ROC) curves. Methods Data of 402 consecutive elderly male patients who underwent polysomnography from 2001 to 2008 were collected. The relationship between apnea hypopnea index(AHI) and obese indexes such as body mass index (BMI), neck circumference (NC), waist circumference (WC) and waist-to-hip ratio (WHR) were analyzed by Pearson's correlation. ROC curves were used to determine the best cutoff values to screen and diagnose OSAHS, and their priority was compared by area under curve (AUC). A two-tailed P value less than 0.05 was considered statistically significant. Statistical analysis was carried out with SPSS version 13.0. Results (1) AHI was positively correlated with BMI (r=0.241,P<0.001), NC(r=0.201,P<0.001), WC(r=0.210,P<0.001) and WHR(r=0. 097,P>0.05)) in elderly male patients. The area under curve (AUC) of BMI, NC, WC and WHR was 0.61, 0.58, 0.51 and 0.45 respectively, and P value was 0.001,0.060,0.840 and 0. 250 respectively. Only BMI was competent in screening and diagnosing OSAHS in elderly male adults; (2) The optimal value of BMI was 22.0 kg/m~2 in screening OSAHS with specificity 90% and rate of missed diagnosis 10%; (3) The optimal value of BMI was 29.0 kg/m~2 in diagnosing OSAHS with specificity 90% and rate of missed diagnosis 10%. Conclusions BMI more than 22.0 kg/m~2 could be the reference standard to screen OSAHS and BMI more than 29.0 kg/m~2 to diagnose OSAHS in elderly men.