利用血氧监测简易诊断儿童OSAHS可行性的临床探索  

The pilot study about the feasibility on the simple diagnosis of pediatric OSAHS by nocturnal pulse oximetry

作　　者：吕明慧[1] 樊韵平[1] 王运中[1] 王静清[1] 洪海裕[1] 陈新野[1] 

机构地区：[1]中山大学附属第五医院耳鼻咽喉头颈外科,519000

出　　处：《中国实用医药》2010年第13期11-13,共3页China Practical Medicine

摘　　要：目的探讨简易的夜间脉搏血氧饱和度(SpO2)监测在初筛甚至确诊儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)中的可行性。方法分析37名疑诊OSAHS儿童的多导睡眠仪(PSG)监测结果,得出每小时SpO2下降≥4%次数,即氧减饱和度指数(CDI4)。将CDI4与呼吸暂停低通气指数(AHI)进行相关性统计学分析。结果非OSAHS组(阻塞性呼吸暂停指数(OAI)<1次/h)6例,和OS-AHS组(OAI≥1次/h,或AHI≥5次/h,伴最低SpO2(LSpO2)<92%)31例。CDI4与AHI正相关,相关系数为:0.876;CDI4与AHI直线回归方程为:Y(AHI)=0.101*X(CDI4)+1.496,R2=0.810,P<0.01;CDI4≥2次/h作为诊断标准时与金标准的一致性较好。结论CDI4与AHI有良好相关性,CDI4与AHI的直线回归方程成立,CDI4可反映呼吸紊乱的频度,CDI4≥2次/h诊断OSAHS时有较高的敏感性和特异性;SpO2监测在初筛甚至确诊儿童OSAHS中有临床实用价值。Objective To investigate the feasibility and reliability of screening even simple diagnosing pediatric Obstructive Sleep Apnea Hypopnea syndrome （OSAHS） only by Pulse Oxygen Saturation （SpO2） monitoring.Methods Analyzed the polysomnographic outcomes of 37 suspected OSAHS children,counted the number of desaturations exceeding 4% per hour （namely Oxygen Desaturation Index,CDI4）,and the statistical correlation between CDI4 and Apnea Hypopnea Index（AHI） was performed.Results The investigated children fell into two groups as non-OSAHS group （Obstructive Apnea Index,OAI 1 time per hour,n=6）,and OSAHS groups （OAI ≥ 1 time/h,or AHI≥5 times/h with Lowest Pulse Oxygen Saturation,LSpO292%,n=31）.CDI4 is correlated positively with AHI,the correlation coefficient （R） is 0.876.The linear regression between CDI4 and AHI comes into existence,and the regression equation is Y （AHI） =0.101X （CDI4） ＋1.496,R2=0.810;CDI4≥2/h is coherent well with PSG when accepted as a diagnostic measure for OSAHS.Conclusion CDI4 correlates well with AHI.The linear regression between CDI4 and AHI has been established well.CDI4 can reflect the frequency of respiratory disturbance.CDI4≥2/h is reliable and special as a diagnostic measure of OSAHS.SpO2 monitoring has good clinical utility in screening even diagnosing pediatric OSAHS.

关 键 词：阻塞性睡眠呼吸暂停综合征 多导睡眠仪 血氧饱和度 诊断 儿童 

分 类 号：R766[医药卫生—耳鼻咽喉科]