柏林问卷在肺栓塞患者中应用的准确性调查

摘要

Objective To investigate the accuracy of Berlin Questionnaire in patients with pulmonary embolism (PE).Methods We retrospectively compared the results of Berlin Questionnaire and sleep study for 101 and 66 subjects with and without PE.Results Totally,74 (73.3％) PE and 46 (69.7％) non-PE patients were diagnosed as obstructive sleep apnea (OSA) by sleep study.Patients with PE demonstrated low accuracy of Berlin Questionnaire assessment,with sensitivity,specificity,positive predictive value,and negative predictive value of 70.3％,48.1％,78.8％ and 37.1％,respectively.Among subjects objectively diagnosed of OSA,fewer PE patients complained of sleepiness than non-PE counterparts [27 (36.5％) vs 26 (56.5％),P =0.032].OSA patients complicated with PE had lower Epworth Scale Score than those without PE (8.6 vs 10.3,P =0.023).Conclusion Berlin Questionnaire yields poorly to diagnose OSA in patients with PE,which may be related to low prevalence of sleepiness in this group.Objective sleep study is indicated for PE patients suspicious of sleep disordered breathing.%目的 明确柏林问卷在肺血栓栓塞症(pulmonary embolism,PE)患者中应用的准确性.方法 研究回顾同一时期接受睡眠监测的101名PE和66名非PE患者,比较柏林问卷与客观检查的差异,确定问卷诊断阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)的准确性.结果 总共74名PE(73.3％)和46名非PE(69.7％)患者被睡眠监测诊断为OSA.在PE患者中,柏林问卷的准确程度相对偏低;灵敏度、特异度、阳性预测值和阴性预测值分别为70.3％、48.1％、78.8％和37.1％.PE患者报告嗜睡的比例显著低于非PE患者[27(36.5％) vs 26(56.5％),P=0.032].PE患者比非PE患者Epworth评分偏低(8.6 vs 10.3,P =0.023).结论 在PE患者中,柏林问卷诊断OSA的准确性较低,与该类型患者嗜睡发生率较低有关.可疑OSA的PE患者需要接受睡眠监测.