压力传感器监测呼吸气流在诊断睡眠呼吸障碍中的价值

The utility of nasal pressure sensor recordings in the diagnosis of sleep disordered breathing

目的探讨压力传感器在诊断睡眠呼吸障碍中的应用价值。方法30例怀疑睡眠呼吸障碍(SDB)的患者经同一套多导生理记录仪于二夜分别应用压力传感器及热敏传感器进行睡眠呼吸监测。多导图由不同的技术员双盲判读。结果两种传感器在识别呼吸暂停时无显著差别,但在监测低通气及上气道阻力增加方面压力传感器更为敏感。30例患者均有白天嗜睡及打鼾,且经CPAP治疗有效,临床上符合SDB的诊断。热敏传感器的诊断敏感性只有73%,压力传感器的敏感性为90%,对AHI在15次/h以上者,二者的敏感性相同,对AHI在15次/h以下者,压力传感器更有价值。结论应用压力传感器监测呼吸气流是诊断睡眠呼吸障碍的一种敏感、可靠的方法,特别是对轻症OSAHS及UARS的诊断价值较大,与临床相关性更好。

Objective To evaluate the diagnostic utility of nasal cannula/pressure transducer （NC） in comparison to thermistor （TH） during routine diagnostic polysomnography （PSG）. Methods Thirty patients with suspected sleep disordered breathing （SDB） were examined using a same PSG system with Th and NP respectively in two consecutive nights. Respiratory events were scored separately utilizing Th and NP in a blinded way. Results NP detected more hypopnea and upper airway resistance increase events than Th （P 〈 0.000 1 ）. Ahhough all 30 patients had daytime sleepiness and snoring and the diagnosis of SDB was confirmed by CPAP treatment, the sensitivity of TH in diagnosing SDB was only 73% ; the sensitivity of NC was 90%. For patients with AHI 〉 15, NC and TH had the same diagnostic value for SDB, however, for patients with AHI 〈 15, NC appeared better for detecting SDB. Conclusion Nasal pressure sensor may detect more respiratory events, and has better utility value than TH in diagnosing patients with upper airway resistance syndrome and mild sleep apnea hypopnea syndrome.