这个病人有阻塞性睡眠呼吸暂停吗? :理性临床检查的系统审查
Kathryn A Myers1, Marko Mrkobrada, David L Simel
1Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. Kathryn.Myers@sjhc.london.on.ca
夜间窒息或喘息是诊断阻塞性睡眠呼吸暂停 (OSA) 的最可靠的临床标志. 打本身不是特定的,但轻度打与低BMI可以表明OSA的可能性较低.
科学领域:
- 睡眠医学 睡眠医学
- 肺部病理学 肺部病理学
- 内部医学 内部医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一种常见的疾病,导致白天嗜睡.
- 在最终测试之前,临床检查对于评估OSA可能性至关重要.
研究的目的:
- 系统地审查OSA临床检查结果的诊断准确性.
- 评估各种症状和迹象在识别OSA时的有用性.
主要方法:
- 对MEDLINE和参考清单 (1966-2013) 的系统审查.
- 包括使用的研究包括参加多睡眠学作为参考标准 (n=42).
- 分析了基于社区和转诊的OSA患病率和症状/征兆的准确性.
主要成果:
- OSA的患病率有很大的差异 (2% - 14%的社区,21% - 90%的转诊).
- 夜间窒息/喘息是一个强烈的指标 (LR 3.3);打不是特定的 (LR 1.1).
- 低BMI (<26) 和轻度打表明OSA的可能性较低 (LR 0.07).
结论:
- 夜间喘气/窒息是最可靠的OSA指标.
- 临床检查有效地帮助选择患者进行进一步的OSA测试.
- 打是常见的,但缺乏OSA的诊断特异性.
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