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中国循证儿科杂志

中国循证儿科杂志 ›› 2017, Vol. 12 ›› Issue (1): 17-21.

• 论著 • 上一篇    下一篇

中文简明儿童阻塞性睡眠呼吸暂停综合征筛查量表信效度和筛查效能

张静1,2，唐铭钰1，江帆2,3，陈洁2,4，殷勇1,2   

  1. 上海交通大学医学院附属上海儿童医学中心1 呼吸科，2 睡眠障碍诊治中心，3 发育行为科，4 耳鼻咽喉科 上海，200127
  • 收稿日期:2016-12-04 修回日期:2017-02-13 出版日期:2017-02-25 发布日期:2017-02-25
  • 通讯作者: 殷勇

The reliability and validity of Chinese version of a short pediatric obstructive sleep apnea syndrome screening scale

ZHANG Jing1,2, TANG Ming-Yu1, JIANG Fan2,3, CHEN Jie2,4, YIN Yong1,2   

  1. 1 Department of Pulmonary Medicine, 2 Sleep Center, 3 Department of Developmental and Behavioral Pediatrics, 4 Department of Otolaryngology, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Received:2016-12-04 Revised:2017-02-13 Online:2017-02-25 Published:2017-02-25
  • Contact: YIN Yong

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摘要：

目的：评价中文版简明儿童阻塞性睡眠呼吸暂停综合征（OSAS）筛查量表（简称量表）在打鼾儿童中的信效度和筛查OSAS的能力。方法：汉化量表，包括问题Q1~Q6。前瞻性收集2015年1月至2015年12月在上海交通大学医学院附属上海儿童医学中心（我院）睡眠门诊和耳鼻咽喉科门诊就诊的、以夜间睡眠打鼾为主诉的、年龄≥3岁的连续病例，在行PSG前由患儿家长回顾孩子近6个月的睡眠情况自行填写量表，以多导睡眠监测（PSG）作为诊断OSAS的金标准（阻塞性呼吸暂停低通气指数（OAHI）每小时≥5次）。考察量表的信度和效度，以OAHI每小时 1次、3次和5次界值分组考察量表筛查儿童OSAS的效能。结果符合本文纳入、排除和剔除标准的425例夜间睡眠打鼾儿童进入本文分析，以OAHI≥每小时5次为诊断标准，82例（19%）被诊断为OSAS（OSAS组），余为非OSAS组。两组性别、最低血氧饱和度和阻塞性呼吸暂停低通气指数（AHI）差异有统计学意义。量表筛查OSAS的整体内在信度克朗巴赫α系数0.785。对量表行探索性因子分析，抽样适度度量为0.783，Bartlett's球形检验P＜0.001，适合进行因子分析，共提取2个因子（对各问题），载荷系数均＞0.5。以OAHI每小时≥5次、3次和1次作为OSAS组和非OSAS组的分组标准时，最佳临界值分别为2.32、2.32和1.99，敏感度均＞65%，特异度50%~60%。结论：量表具有较好的信度和效度，可以快速有效地用于在夜间打鼾儿童中筛查中重度OSAS。

Abstract:

ObjectiveTo evaluate the validity and reliability of Chinese version of a short obstructive sleep apnea syndrome (OSAS) screening scale in snoring children and its screening ability. MethodsThe scale was translated and retranslated. Consecutive snoring children (ages above 3 years) were prospectively recruited from the sleep and otolaryngology clinic in Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine from January 2015 to December 2015. Prior to the overnight PSG test, the parents needed to review the child's sleep situation for nearly 6 months and filled out the scale themselves. PSG was taken as the gold standard for diagnosing of OSAS (obstructive apnea hypopnea index (OAHI) ≥ 5 times/h). The reliability and validity of the screening scale were tested and the screening efficacy of the OSAS was calculated with the cutoff points as OAHI 1 times/h, 3 times /h and 5 times/h. ResultsA total of 425 children were ultimately included in the study. Of them, 82 (19%) children were diagnosed as OSAS group by PSG (OAHI≥5/h), others were non-OSAS group. There was significant difference in the gender, nadir SpO2 and OAHI (P ＜0.05) between the OSA group and non-OSA group. The internal consistency of overall questionnaire was good（Cronbach's alpha coefficient was 0.785）. In the exploratory factor analysis, KMO was 0.783, Bartlett 's spherical test P ＜ 0.001, was suitable for factor analysis. Two factors (Q1~Q6 problem) were extracted and both loading factors were above 0.5. The optimal cutoff values were 2.32, 2.32 and 1.99, with the sensitivity＞ 65% and the specificity of 50% to 60% when OAHI≥5, ≥3, ≥1 times / h were used as the grouping standard for OSAS group and non-OSAS group.ConclusionReliability and validity of Chinese version of the short OSAS questionnaire are good. It appears to be an efficient instrument for screening moderate to severe pediatric OSAS in snoring children.