智能动态血氧仪诊断睡眠呼吸暂停低通气综合征与多导睡眠图监测的一致性研究

目的：睡眠呼吸暂停低通气综合征(sleep apnea hypopnea syndrome,SAHS)是临床最常见的睡眠疾病之一,多导睡眠图监测为诊断的金标准。本研究将一种可无线传输数据至云平台并自动分析数据的腕表式智能动态脉搏血氧仪(简称“腕式血氧仪”)作为研究对象,与标准的多导睡眠图(polysomnography,PSG)监测做一致性分析,探讨腕式血氧仪对 SAHS诊断的可靠性。方法受试者为2015年6月至2016年2月就诊于首都医科大学附属北京朝阳医院呼吸科睡眠中心的疑似SAHS患者,所有受试者同时完成整夜 PSG监测和腕式血氧仪监测,分别比较 PSG和腕式血氧仪计算的氧减指数(oxygen desatuation index, ODI)、最低血氧饱和度(lowest percutaneous oxygen saturation,LSpO2)、<90%的血氧饱和度时间比率(the percentage of time spent at SpO2 below 90%, TS90%)和经皮平均血氧饱和度(mean percutaneous oxygen saturation,MSpO2)。并将 PSG 监测的呼吸暂停低通气指数(apnea hypopnea index,AHI)与腕式血氧仪监测的 ODI做一致性分析。用受试者工作特征(ROC)曲线评定 ODI诊断价值及判定诊断SAHS的界值。结果本研究共纳入201例受试者,PSG与腕式血氧仪监测的 ODI、TS90%、LSpO2之间差异无统计学意义；腕式血氧仪 ODI 与PSG监测的 AHI具有良好的相关性；ROC 曲线评价腕式脉搏血氧 ODI>10.4次/h 对 SAHS 的诊断价值敏感性及特异性均较高。结论 SAHS动态血氧波形有比较明显的特征,腕式血氧仪测得的 ODI可反应睡眠呼吸暂停的情况,可作为 SAHS的初筛设备。

Correlation of cloud platform wearable medical device and polysomnograghy in diagnozing sleep apnea ;hypopnea syndrome

Objective Sleep apnea hypopnea syndrome (SAHS) is one of the most common sleep disorders.The obj ective of this research is to compare the cloud platform wearable medical device (portable pulse oximetry) with polysomnography (PSG),evaluating the correlation of this two device in the diagnosis of SAHS.Methods Subjects in the study were inrolled in sleep center of Beijing Chaoyang Hospital affiliated to Capital Medical University from June 2015 to February 2016.All subjects underwent PSG and portable pulse oximetry on the same night.Compare lowest percutaneous oxygen saturation (LSpO2),the percentage of time spent at SpO2 below 90% (TS90%),mean percutaneous oxygen saturation(MSpO2)from this two device.The correlation between apnea hypopnea index(AHI)from PSG and oxygen desatuation index (ODI) from PPO were evaluated.actigraphy.Receiver operating characteristic(ROC) curve was used for evaluating the value of ODI for diagnosing SAHS and cut-off value was calculated.Results A total of 201 subjects were included in this study.There was no significant difference in ODI,TS90%,LSpO2 between the two device.There was a statistically significant association between ODI and AHI(r=0.833,P<0.01).ROC curve revealed ODI>10.4 times/h from PPO a high specificity(82.4%) and insensitivity (86.4%) in the diagnosis of SAHS.Conclusions The high correlation between PPO and PSG makes this potable device to be an ideal screening tool in diagnosing SAHS with high efficiency and low cost.