C+手环对成人睡眠呼吸暂停低通气综合征的初筛价值

目的 探讨C+手环对成人睡眠呼吸暂停低通气综合征(sleep apnea hypopnea syndrome,SAHS)的初筛价值.方法 对145例疑似SAHS患者同时进行多导睡眠图(polysomography,PSG)与C+手环监测,分别统计PSG监测所得睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)、PSG与C+手环监测所得氧减饱和度指数(oxygen desaturation index,ODI4)、平均血氧饱和度(MSaO2)、最低血氧饱和度(LSaO2)以及血氧饱和度＜90％占整个记录时间的百分比(TS90％).结果 C+手环监测所得ODI4与PSG监测所得AHI两者显著相关(r=0.711,P＜0.001).C+手环与PSG监测所得ODI4、LSaO2、MSaO2以及TS90％进行相关性分析(r分别为0.708、0.575、0.486、0.631,P值均＜0.001).分别以PSG-AHI≥5次/h作为诊断SAHS的阳性标准,C+手环监测所得ODI4≥5次/h作为诊断SAHS的初筛标准,配对矿检验显示差异无统计学意义(x2=1.71,P＞0.05,Kappa值=0.524,P＜0.001).以PSG-AHI≥5次/h作为诊断SAHS的阳性标准,以C+手环监测所得ODI4≥11.45次/h作为SAHS初筛标准,灵敏度为77.4％,特异度为83.9％,以ODI4≥15.45次/h作为初筛标准,其对应特异度为90.3％,灵敏度为68.9％.结论 C+手环对SAHS有一定的初筛价值,可作为一种便携式筛查工具.

Value of C plus band for the screening of sleep apnea hypopnea syndrome

Objective To explore the value of C plus vital sign monitoring band for the screening of sleep apnea hypopnea syndrome (SAHS).Methods One hundred and forty-five suspect SAHS patients are monitored for polysomography (PSG) and C plus band.Apnea hypopnea index (AHI),oxygen desaturation index 4 (ODI4),the mean SaO2 (MSaO2),the lowest SaO2 (LSaO2),the total time with oxygen saturation level ＜ 90％ were calculated.Results There was a significant correlation between C plus band OID4 and PSG-AHI(r =0.711,P ＜ 0.001).ODI4,LSaO2,MSaO2 and the total time with oxygen saturation level＜90％ showed a significant correlation (r =0.708,0.575,0.486,0.631,P values all less than 0.001).When PSG-AHI≥5 events per hour was setting as the threshold value to diagnose SAHS,ODI4 ≥5 events per hour of C plus band as the screening criteria,paired chi square test showed no statistical difference(P ＞ 0.05),kappa =0.524,P ＜ 0.001.When PSG-AHI≥ 5 events per hour was setting as the threshold value to diagnose OSAHS,ODI4≥11.45 events per hour of C plus band identified patients at a sensitivity of 77.4％ and a specificity of 83.9％,ODI4≥15.45 events per hour of C plus band identified patients at a specificity of 90.3 ％ and a sensitivity of 68.9 ％.Conclusions The C plus band was proved as a portable and reliable device of screening patients who were suspected SAHS.