首页|一种儿童阻塞性睡眠呼吸暂停综合征临床预测模型的建立

一种儿童阻塞性睡眠呼吸暂停综合征临床预测模型的建立

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  • NETL
  • NSTL
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目的:构建并验证一种简易的儿童阻塞性睡眠呼吸暂停综合征(OSAS)临床预测模型.方法:筛选多导睡眠监测(PSG)95例2～12岁儿童患者的临床数据,根据阻塞性呼吸暂停低通气指数(OAHI)≤1分为非OSAS组(n=22),OAHI＞1为OSAS组(n=73),收集并对比两组的性别、年龄、体质指数(BMI)、夜间最低脉搏血氧饱和度(SpO2)、扁桃体分级及腺样体分度情况,并对上述变量进行研究,采用二元Logistic回归分析法对数据进行统计分析,建立儿童OSAS临床预测模型.结果:OSAS组患者的年龄、BMI、夜间脉搏最低血氧饱和度(SpO2)、扁桃体分级、腺样体分度等指标与非OSAS组比较,均有显著性差异(P＜0.05),性别无显著性差异;模型方程为:X=2.366-0.769(年龄-连续变量)±0.248(BMI-连续变量)-3.413(SpO2-连续变量)+2.104(扁桃体分级为Ⅲ～Ⅳ级"是");Hosmer-Lemeshow检验为P=0.612(P＞0.05),内部验证的AUC为0.821(0.713-0.929,P＜0.01),敏感度为 83.3％,特异度为 76.4％;外部验证的准确度为 73.8％,AUC 为 0.805(0.664-0.943,P＜0.01),敏感度84.6％,特异性为75％.结论:该预测模型对2～12岁儿童的阻塞性睡眠呼吸暂停综合征可能有较好的预测效能,可辅助临床医师诊断儿童OSAS.
A clinical prediction model for pediatric obstructive sleep apnea syndrome
Objective:To establish and verify a simple clinical prediction model for obstructive sleep apnea syndrome(OSAS)in children.Methods:The clinical data of 95 children aged 2-12 years underwent polysomnography(PSG)were screened.The subjects with OAHI≤1 were included into non-OSAS group(n=22)and those with OAHI＞1 into OSAS group(n=73).Gender,age,body mass index(BMI),night pulse minimum oxygen saturation(SpO2),tonsil grading and adenoid grading of the 2 groups were compared and analyzed.Binary Logistic regression analysis was used to statistically analyze the data and establish a clinical prediction model for OSAS in children.Results:There was significant difference in age,BMI,SpO2,tonsil grading and adenoid grading between the 2 groups(P＜0.05),there was no significant gender difference(P＞0.05).The model equation was as follows:X=2.366-0.769(age-continuous variable)+0.248(BMI-continuous variable)-3.413(SPO2-continuous variable)+2.104(tonsil grade Ⅲ-Ⅳ"yes").The result of internally validated Hosmer-Lemeshow test was P=0.612(P＞0.05),AUC was 0.821(0.713-0.929,P＜0.01),sensi-tivity was 83.3％,specificity was 76.4％.The accuracy of external validation was 73.8％,the AUC was 0.805(0.664-0.943,P＜0.01),the sensitivity was 84.6％and the specificity was 75％.Conclusion:The predictive model may have good predictive efficacy for 2-12 years old children with OSAS,and may assist clinicians in diagnosing children with OSAS.

Obstructive sleep apnea syndromePrediction modelEarly screeningChildrenObstructive apnea hypopnea index

聂文瑶、常乾、符倩、张细萱、秦子洋、范杰、任利玲

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730000,兰州大学口腔医学院

甘肃省人民医院睡眠医学中心

阻塞性睡眠呼吸暂停综合征 预测模型 早期筛查 儿童 阻塞性呼吸暂停低通气指数

兰州大学新医科交叉创新训练计划(2020)兰州大学口腔医院科研扶持基金(2019)兰州大学大学生创新创业训练计划(2021)兰州大学口腔医院科研项目

本科交叉-2020-19533000-07110002920210150013lzukqky-2022-t01

2024

10.3969/j.issn.1001-3733.2024.03.015

实用口腔医学杂志
第四军医大学口腔医学院

实用口腔医学杂志

CSTPCD北大核心
影响因子：0.942
ISSN：1001-3733
年,卷(期)：2024.40(3)
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