动态心电图在睡眠呼吸暂停综合征筛查中的应用价值

Application value of ambulatory electrocardiography examination in screening sleep apnea syndrome

目的探讨动态心电图在睡眠呼吸暂停综合征(sleep apnea syndeome,SAS)筛查中的应用价值。方法选择有不同程度睡眠鼾症的121例患者进行动态心电图检查。采用DMS公司的第二代SAS初筛技术,同步提取动态心电图与呼吸波,并同步对患者行多导睡眠图(polysomnography,PSG)检查,进行阳性率比较。结果 121例患者中,PSG阴性40例、阳性81例,阳性患者中轻度25例、中度42例、重度14例。动态心电图检查阴性46例、阳性75例。动态心电图与PSG监测出的阳性患者72例相吻合。其中,两者对中、重度患者诊断的阳性率一致,但对于轻度患者动态心电图检出率偏低,并出现假阳性现象。动态心电图对中、重度SAS的阳性检出率明显高于轻度患者,差异有统计学意义(P<0.05)。结论动态心电图是简便、实用和可靠的检测SAS的方法,对该病有较好的筛查效果,可用于临床诊断。

Objective To investigate the application value of ambulatory electrocardiography（ AECG） examination in screening sleep apnea syndrome（ SAS）.Methods AECG examination was performed on 121 patients with different degrees of sleep snoring.AECG and respiratory waves were extracted synchronously with second-generation SAS initial screening technology by DMS Company.Meanwhile,polysomnography（ PSG） examination was performed on the patients and positive rate was compared.Results In 121 enrolled patients,PSG examination reported 40 negative cases and 81 positive ones including 25 with mild SAS,42 with moderate SAS and 14 with severe SAS.AECG examination found 46 negative cases and 75 positive ones.There were 72 cases found positive both in AECG examination and PSG monitoring.The diagnostic positive rate of AECG and PSG were coincident for patients with moderate and severe sleep snoring.However,the detection rate of AECG was comparatively lower in patients with mild sleep snoring,and false positive phenomenon was observed.For moderate and severe SAS patients,the positive detection rate of AECG was significantly higher than that of mild cases,with statistically significant difference（ P〈0.05）.Conclusion AECG is an easy,convenient,practical and reliable method to detect SAS.For its great effect in screening SAS,AECG can be recommended for clinical diagnosis.