C＋手环对成人睡眠呼吸暂停低通气综合征的初筛价值

Value of C plus band for the screening of sleep apnea hypopnea syndrome

目的探讨C＋手环对成人睡眠呼吸暂停低通气综合征（sleep apnea hypopnea syndrome，SAHS）的初筛价值。方法对145例疑似SAHS患者同时进行多导睡眠图（polysomography，PSG）与c＋手环监测，分别统计PSG监测所得睡眠呼吸暂停低通气指数（apnea hypopnea index，AHI）、PSG与C＋手环监测所得氧减饱和度指数（oxygen desaturation index，ODl4）、平均血氧饱和度（MSaOz）、最低血氧饱和度（LSaO2）以及血氧饱和度〈90％占整个记录时间的百分比（TS90％）。结果C＋手环监测所得ODl4与PSG监测所得AHI两者显著相关（r=0．7ll，P〈0．001）。C＋手环与PSG监测所得ODl4、LSa02、MSaO2以及T$90％进行相关性分析（r分别为0．708、0．575、0．486、0．631，P值均〈O．001）。分别以PSG-AHI≥5次／h作为诊断sAHS的阳性标准，C＋手环监测所得ODl4≥5次／h作为诊断SAHS的初筛标准，配对x。检验显示差异无统计学意义（X^2=1．71，P〉0．05，Kappa值-0．524，P〈0．001）。以PSG-AHI≥5次／h作为诊断SAHS的阳性标准，以C＋手环监测所得ODl4≥11．45次／h作为SAHS初筛标准，灵敏度为77．4％，特异度为83．9％，以ODl4≥15．45次／h作为初筛标准，其对应特异度为90．3％，灵敏度为68．9％。结论C＋手环对SAHS有一定的初筛价值，可作为一种便携式筛查工具。

Objective To explore the value of C plus vital sign monitoring band for the screening of sleep apnea hypopnea syndrome （SAHS）. Methods One hundred and forty-five suspect SAHS patients are monitored for polysomography （PSG） and C plus band. Apnea hypopnea index （AHI）, oxygen desaturation index 4 （ODI4）, the mean SaO2 （ MSaO2 ）, the lowest SaO2 （ LSaO2 ）, the total time with oxygen saturation level 〈 90% were calculated. Results There was a significant correlation between C plus band-OID4 and PSG-AHI（ r = 0. 711, P d0.001）. ODI4, LSaO2, MSaO2 and the total time with oxygen saturation level〈90 % showed a significant correlation （ r - 0. 708,0. 575,0. 486,0. 631, P values all less than 0. 001）. When PSG-AHI≥5 events per hour was setting as the threshold value to diagnose SAHS, ODI4 ≥5 events per hour of C plus band as the screening criteria, paired chi square test showed no statistical difference（P 〉0.05）,kappa：0.524, P 〈M0.001.When PSG-AHI≥5 events per hour was setting as the threshold value to diagnose OSAHS, ODI4≥11.45 events per hour of C plus band identified patients at a sensitivity of 77.40/oo and a specificity of 83.9o/00, ODI4≥15.45 events per hour of C plus band identified patients at a specificity of 90.3 % and a sensitivity of 68.9 %. Conclusions The C plus band was proved as a portable and reliable device of screening patients who were suspected SAHS.