睡眠呼吸暂停综合征患者检测动态心电图和SPO2的临床意义  

Clinical significance of dynamic electrocardiogram and SPO2 detection in patients with sleep apnea syndrome

作　　者：张淑静 郝振民[2] 徐从恩 ZHANG Shujing;HAO Zhenmin;XU Cong’en(Department of Functional Examination ,The Third People’s Hospital of Hengshui City, Hebei, Hengshui 053000,China)

机构地区：[1]河北省衡水市第三人民医院功能科,053000 [2]哈励逊国际和平医院医技科 [3]河北省衡水市精神病医院功能科

出　　处：《河北医药》2019年第24期3717-3721,共5页Hebei Medical Journal

基　　金：河北省卫计委医学科学研究重点课题(编号:20171230)

摘　　要：目的研究睡眠呼吸暂停综合征(SAS)患者动态心电图和夜间血氧饱和度(SPO2)变化特点,探讨动态心电图推导呼吸曲线(EDR)技术获得呼吸暂停低通气指数(AHI)指数联合夜间SPO2监测获得氧减指数(ODI)指数对SAS的诊断价值。方法前瞻性选择106例疑似SAS患者为研究对象,患者均接受多导睡眠检测(PSG)、EDG、夜间SPO2监测,获得AHI、ODI指数,并收集患者临床资料,Logistic回归分析AHI、ODI与SAS发病的相关性。以PSG诊断结果为标准,受试者工作特征曲线(ROC)分析AHI、ODI、AHI联合ODI诊断SAS的效能。结果PSG诊断SAS患者共59例,SAS阳性组患者AHI、ODI高于SAS阴性组(P<0.05)。Logistic回归分析AHI(Or=2.067,P=0.005)、ODI(Or=1.978,P=0.000)是SAS的独立预测因子。AHI联合ODI诊断SAS的AUC为0.988(95%CI:0.971~1.000,P=0.000)高于单独AHI[0.961(95%CI:0.930~0.993,P=0.000)]、ODI[0.931(95%CI:0.879~0.982,P=0.000)]诊断,灵敏度和特异度均达95.00%以上。结论应用动态心电图联合SPO2监测可提高SAS患者筛查准确率,可作为临床辅助诊断工具。Objective To investigate the changes of dynamic electrocardiogram(DCG)and saturation O2(SPO2)in patients with sleep apnea syndrome(SAS),and to explore the diagnostic value of Apnea Hypopnea Index(AHI)obtained by ECG-derived respiratory signals(EDR)technique combined with oxygen loss index(ODI)obtained by nocturnal SPO2 monitoring.Methods A total of 106 patients with suspected SAS were prospectively selected.All the patients were monitored by polysomnography(PSG),EDG and night SPO2 to obtaine AHI and ODI indexes.And the clinical data of patients were collected,Logistic regression was used to analyze the correlation between AHI,ODI,SAS and pathogenesis of SAS.Based on the diagnostic results of PSG,receiver operator characteristic(ROC)was used to analyze the efficacy of AHI,ODI and AHI combined with ODI in diagnosis of SAS.Results There were 59 cases of SAS diagnosed by PSG.The AHI and ODI in SAS positive group were significantly higher than those in SAS negative group(P<0.05).Logistic regression analysis showed that AHI and ODI were independent predictors of SAS(P<0.01).The AUC of SAS diagnosed by AHI combined with ODI was 0.988(95%CI:0.971~1.000),P<0.01),which was significantly higher than that diagnosed by AHI alone and ODI alone(P<0.01),with sensitivity and specificity being more than 95.00%.Conclusion Dynamic electrocardiogram combined with SPO2 monitoring can improve the accuracy of screening for SAS,which can be used as a clinical auxiliary diagnostic tool.

关 键 词：睡眠呼吸暂停综合征 EDR SPO2 AHI ODI 

分 类 号：R56[医药卫生—呼吸系统]