腕表式睡眠监测在高原睡眠呼吸暂停低通气综合征中的诊断价值  

The Diagnostic Value of Watch Sleep Monitoring in OSAHS at High Altitude

作　　者：庞怀霞[1] 郝丽娟[1] 马祯[1] 陕卫珍 黄祥荣 常春梅 杨宝良 Pang Huaixia;Hao Lijuan;Ma Zhen;Shan Weizhen;Huang Xiangrong;Chang Chunmei;Yang Baoliang(Department of Sleep Medicine,Qinghai Red Cross Hospital,Xining 810000,China)

机构地区：[1]青海红十字医院睡眠医学科

出　　处：《世界睡眠医学杂志》2019年第12期1667-1670,共4页World Journal of Sleep Medicine

基　　金：青海省卫生和计划委员会指导性课题项目(2016-wjzdx-66)

摘　　要：目的:了解腕表式睡眠监测在高原OSAHS患者诊断中的准确性,并明确腕表式睡眠监测与多导睡眠监测(PSG)的一致性,进而判断腕表式睡眠监测在临床诊断OSAHS中的可靠程度。方法:随机选取2018年1月1日至2018年12月31日在青海红十字医院睡眠医学科就诊的可疑OSHAS患者100例,征得患者同意后同步行腕表式睡眠监测、整夜多导睡眠监测,比较2组监测结果数据,进行统计学分析。结果:两组检查结果中,AHI、最长呼吸暂停时间对比,差异具有统计学意义(P<0.05);OSAHS患者病情程度越重,腕表式睡眠筛查的诊断率越高(Kappa值0.21,P<0.05);两种监测方法中最低血氧饱和度分组情况进行Kappa一致性分析,绝对一致(Kappa值1,P<0.05);中、重度高原OSAHS患者中腕表睡眠筛查仪诊断一致性明显偏高(ROC曲线下AUC=0.9,P=0.018,AHI=11.95,敏感度98%,特异性100%)。结论:RS01睡眠监测筛查仪的特异性随着OSAHS严重程度而逐渐升高,2种监测结果的最低血氧饱和度、平均血氧饱和度一致性高,临床有很大的应用价值,腕表监测不能准确反应OSAHS的病情程度,对于轻中度患者,容易造成较实际情况偏轻的情况,但基本能满足对OSAHS的筛查和诊断。Objective:To understand the accuracy of wrist watch sleep monitoring in the diagnosis of OSAHS at high altitude,and to determine the consistency between wrist watch sleep monitoring and PSG,so as to judge the reliability of wrist watch sleep monitoring in the clinical diagnosis of OSAHS.Methods:From January 1,2018 to December 31,2018,100 patients with suspected OSHAS were randomly selected from the Department of sleep medicine of Qinghai Red Cross Hospital.With the consent of the patients,wrist watch sleep monitoring and all night multi-channel sleep monitoring were performed simultaneously.The monitoring results of the two groups were compared for statistical analysis.Results:The difference between the two groups was statistically significant(P<0.05);the more serious the condition of OSAHS patients was,the higher the diagnostic rate of wrist sleep screening was(kappa value 0.21,P<0.05);kappa consistency analysis was carried out for the grouping of the lowest blood oxygen saturation degree in the two monitoring methods,which was absolutely consistent(kappa value 1,P<0.05).The diagnostic consistency of wrist watch sleep screening instrument in OSAHS patients at moderate and severe altitude was significantly higher(AUC=0.9,P=0.018,AHI=11.95,sensitivity 98%,specificity 100%).Conclusion:The specificity of RS01 sleep monitoring and screening instrument gradually increases with the severity of OSAHS.The minimum and average blood oxygen saturation of the two monitoring results are highly consistent,which is of great clinical application value.RS01 sleep monitoring can not accurately reflect the condition of OSAHS.For light and medium-sized patients,it is easy to cause lighter than the actual situation,but it can basically meet the screening of OSAHS And diagnosis.

关 键 词：OSAHS 腕表式睡眠监测 PSG 一致性 敏感性 

分 类 号：R163[医药卫生—公共卫生与预防医学] R338.63