基于阻塞性睡眠呼吸暂停低通气综合征患儿睡眠结构探究微动敏感床垫式睡眠监测结果判读精确性  

Exploration of the accuracy of interpretation of micro-movement sensitive mattress sleep monitoring system based on the sleep structure of children with obstructive sleep apnea hypopnea syndrome

作　　者：郑慧珍 刘杰 张瑜 刘绪明 ZHENG Huizhen;LIU Jie;ZHANG Yu;LIU Xuming(Department of Otolaryngology,Wenzhou People's Hospital in Zhejiang Province,Wenzhou325000,China;Department of Radiology,Wenzhou People's Hospital in Zhejiang Province,Wenzhou325000,China)

机构地区：[1]浙江省温州市人民医院耳鼻咽喉科,浙江温州325000 [2]浙江省温州市人民医院影像科,浙江温州325000

出　　处：《中国现代医生》2020年第25期81-84,88,F0003,共6页China Modern Doctor

基　　金：浙江省自然科学基金项目(LSY19H090001);浙江省温州市科技局医疗卫生科技项目(Y20170794)。

摘　　要：目的基于阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿睡眠结构,探究微动敏感床垫式睡眠监测系统(MSMSMS)结果精确性。方法选取我院2018年3月~2019年3月收治的确诊为OSAHS的患儿74例,采用随机数字法均分为观察组和对照组,观察组行MSMSMS监测,对照组行多导睡眠监测仪(PSG)检测。比较两组患儿睡眠呼吸低通气次数(AH)、最低血氧饱和度(LSaO2)、呼吸暂停低通气指数(AHI)、睡眠呼吸暂停(SA)及夜间动腿(NML)发生情况;采用ROC曲线考察不同睡眠状态下MSMSMS诊断OSAHS的效能,采用符合率分析不同睡眠结构下微动敏感床垫式睡眠监测结果判读精确性。结果观察组患儿的AH、AHI显著高于对照组,而LSaO2显著低于对照组(P<0.05)。观察组睡眠呼吸暂停(SA)及夜间动腿(NML)发生情况均较对照组显著高(P<0.05)。在快动眼睡眠及慢动眼睡眠时相下,MSMSMS相对于PSG的ROC曲线下面积(AUC)分别为0.847、0.923(P<0.05);睡眠时相为慢动眼睡眠,AHI阈值为20次/h,MSMSMS监测结果与PSG最为接近。且MSMSMS对醒觉-睡眠的监测结果与PSG更接近。结论MSMSMS可灵敏的监测患儿睡眠相关指标,与PSG监测结果接近,具有良好的临床推广价值。Objective To explore the accuracy of the results of micro-movement sensitive mattress sleep monitoring system based on the sleep structure of children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Seventy-four children diagnosed with OSAHS who were admitted to our hospital from March 2018 to March 2019 were selected.The patients were divided into an observation group and a control group by random number method.The observation group was monitored by MSMSMS,and the control group was monitored by polysomnography(PSG)detection.The incidence of sleep apnea hypopnea(AH),minimum blood oxygen saturation(LSaO2),apnea hypopnea index(AHI),sleep apnea(SA)and nocturnal movement of limb(NML)between the two groups were compared.The ROC curve was used to examine the effectiveness of MSMSMS in diagnosing OSAHS in different sleep states.The coincidence rate was used to analyze the accuracy of the results of micro-movement sensitive mattress sleep monitoring under different sleep structures.Results The AH and AHI in the observation group were significantly higher than those of the control group,while LSaO2 in the observation group was significantly lower than that of the control group(P<0.05).The incidence of sleep apnea(SA)and nocturnal movement of limb(NML)in the observation group were significantly higher than those in the control group(P<0.05).Under fast-moving eye sleep and slow-moving eye sleep phases,the area under the ROC curve(AUC)of MSMSMS relative to PSG was 0.847 and 0.923(P<0.05),respectively;the sleep phase was slow-moving eye sleep,and the AHI threshold was 20 times/h;the MSMSMS monitoring result was closest to PSG.And the monitoring results of awake-sleep by MSMSMS are closer to PSG.Conclusion MSMSMS can sensitively monitor children’s sleep-related indicators,which is close to PSG monitoring results,and has good clinical promotion value.

关 键 词：多导睡眠监测仪 阻塞性睡眠呼吸暂停低通气综合征 微动敏感床垫式睡眠监测系统 ROC曲线 

分 类 号：R5[医药卫生—内科学]