心肺耦合分析在评估OSAHS睡眠质量的价值  

The value of cardiopulmonary coupling analysis in measuring sleep quality of obstructive sleep apnea hypopnea syndrome

作　　者：罗金梅[1] 肖毅[1] 黄蓉[1] 钟旭[1] 陈娟[1] 

机构地区：[1]中国医学科学院 北京协和医学院 北京协和医院呼吸内科,100730

出　　处：《国际呼吸杂志》2016年第10期767-771,共5页International Journal of Respiration

基　　金：国家科技支撑计划课题（2012BA105802）

摘　　要：目的 OSAHS漏诊率高,许多便携式设备不能评估OSAHS的睡眠质量,本文旨在评价心肺耦合分析在评估OSAHS睡眠质量的价值.方法 回顾性分析2010年2月至2011年10月于北京协和医院睡眠呼吸中心进行整晚多导睡眠监测的患者110例,根据呼吸暂停低通气指数（AHI）分为AHI正常组、OSAHS组;OSAHS组分为轻度、中度和重度OSAHS组.比较各组的多导睡眠图和心肺耦合谱,并分析多导睡眠图和心肺耦合谱的相关关系;应用ROC曲线确定睡眠质量正常的阈值.结果 OSAHS组的高频耦合（HFC）、高频耦合/低频耦合（HFC/LFC）比正常AHI组减少,而低频耦合（LFC）、抬高型的低频耦合（e-LFC）比正常AHI组增多.HFC与AHI呈强负相关（r=-0.791,P＜0.01）,LFC、e-LFC与AHI呈强正相关（LFC：r=0.791;e=LFC：r=0.791,P＜0.01）;当HFC≥44.55％时,判断睡眠质量正常敏感度是73.3％,特异度是68.8％.结论 OSAHS的心肺耦合谱表现为高频耦合减少,低频耦合增多,心肺耦合谱结果与OSAHS的严重程度相关.心肺耦合分析可以辅助便携式设备评估OSAHS患者的睡眠质量.Objective Obstructive sleep apnea hypopnea syndrome （OSAHS） was still underdiagnosed and most portable sleep monitor devices couldn＆#39;t measure the sleep quality of OSAHS.This study evaluated the role of cardiopulmonary coupling （CPC） in measuring the sleep quality of OSAHS.Methods 110 patients undergoing diagnostic overnight PSG from February 2010 to October 2011 in the sleep disordered center of Peking Union Medical College Hospital were retrospectively included in this study.Patients were classified into normal AHI group,OSAHS group and the OSAHS patients were classified into mild OSAHS group,moderate OSAHS group and severe OSAHS group.The PSGs and CPC results of each group were compared and the relation of variables of PSG and CPC were analyzed.Using ROC calculated the cut-off of normal sleep quality.Results OSAHS patients had less high frequency coupling （HFC） and high frequency coupling/low frequency coupling （HFC/LFC）,more LFC and e-LFC than normal AHI patients.The amount of HFC was strongly negatively related with AHI （r =-0.791,P 〈0.01） while the amount of LFC,e-LFC were strongly positively related with AHI （r =0.791,0.791,respectively,P 〈 0.01）.The variables of CPC were weakly related with sleep staging of PSG.When using HFC≥44.55 % as the cut-off of normal sleep quality,the sensitivity was 73.3%,and the specificity was 68.8%.Conclusions OSAHS patients have less HFC and more LFC.HFC and LFC are strongly related with the severity of OSAHS.CPC analysis can measure the sleep quality of OSAHS patients as a supplementary tool.

关 键 词：阻塞性睡眠呼吸暂停 多导睡眠图 睡眠质量 

分 类 号：R766[医药卫生—耳鼻咽喉科]