数字化信息监测与控制系统在睡眠呼吸暂停综合征诊断中的应用价值

Evaluation of digital area medicine information cybernetic system in diagnosing obstructive sleep apnea hypopnea syndrome

目的评价数字化全病区医学信息监测与控制系统（digital area medicine information cybernetic system,DAMICS）在睡眠呼吸暂停综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）中的诊断价值。方法收集2014年9月-2015年4月在我院呼吸内科就诊的76例打鼾患者,男64例,女12例,年龄18~81（46.58±14.32）岁。对每名患者同时进行1次7 h的DAMICS监测和多导睡眠监测（polysomnography,PSG）,以PSG的呼吸暂停低通气指数（apnea hypopnea index,AHI）为诊断OSAHS的金标准,对PSG和DAMICS监测所得出的AHI做比较,评价其诊断价值。结果以PSG所测AHI分组,DAMICS-AHI和PSG-AHI在轻度组中的差异无统计学意义（P〉0.05）。以DAMICS所测AHI分组,两者在鼾症组和轻度组中的差异无统计学意义（P〉0.05）。DAMICS-AHI和PSG-AHI呈正相关（r=0.967,P=0.000）,以PSG-AHI≥5作为诊断金标准绘制ROC曲线,得出DAMICS-AHI≥7.6时,约登指数最大,灵敏度93.8%,特异度100%。以PSG-AHI≥15绘制ROC曲线,得出中重度患者DAMICS-AHI最佳诊断点为14.15,灵敏度93.9%,特异度96.3%。结论 DAMICS对OSAHS的诊断准确性高,有较大的临床应用价值。

Objective To analyze the diagnostic value of digital area medicine information cybernetic system（DAMICS） in diagnosing obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Seventy-six patients [male 64, female 12, with a mean age of（46.58±14.32）] with suspected OSAHS were monitored by DAMICS and polysomnography（PSG） for 7 h. The apnea hypopnea index（AHI） of PSG served as gold standard for the diagnosis of OASHS. The diagnostic value was evaluated by comparing PSG-AHI with DAMICS-AHI. Results There was no significant difference in mild patients according to groups of PSGAHI（P〉0.05）. There was no significant difference in stertorous and mild patients according to groups of DAMICS-AHI（P〉0.05）. Significant positive correlation was found between DAMICS-AHI and PSG-AHI（r=0.967, P=0.000）. With PSG-AHI≥5 as the diagnostic standard of OSAHS and PSG-AHI≥15 as diagnostic of severe OSAHS, receiver operating characteristic（ROC） curves were drawn. According to ROC curves, a cut-off point of 7.6 was identified as the best point for diagnosing OSAHS with sensitivity of 93.8% and specificity of 100%. Another cut-off point of 14.15 was identified as the best point for diagnosing severe OSAHS with sensitivity of 93.9% and specificity of 96.3%. Conclusion DAMICS is a valuable device with highly sensitivity and specificity in diagnosis of OSAHS.