午间便携式睡眠监测加诊断性治疗在OSAHS患者中的诊断价值

Diagnostic Value of Midday Portable Sleep Monitoring Plus Diagnostic Treatment in Patients with OSAHS

目的观察午间便携式睡眠监测加诊断性治疗在OSAHS患者中的诊断价值。方法选取2015年1月—2018年1月因睡眠相关疾病在邵阳市中心医院呼吸门诊就诊,ESS评分≥9分,且无冠心病、COPD、脑血管疾病的患者,共231例,231例患者午间前1 h进行便携式睡眠监测,后1 h进行CPAP诊断性治疗,并于当日夜间进行PSG监测,比较午间便携式睡眠监测加诊断性治疗与单纯午间便携式睡眠监测的确诊OSAHS敏感度和特异度。结果经过PSG监测,231例患者中,有186例患者确诊为阻塞性睡眠呼吸暂停低通气综合征,午间便携式睡眠监测仪的检测敏感度为78.0%,特异度为84.4%;午间便携式睡眠监测加诊断性治疗的敏感度为93.5%,特异度为95.6%。午间便携式睡眠监测仪加诊断性治疗的诊断敏感度、特异度高于单纯便携式睡眠呼吸监测仪,其差异有统计学意义(P<0.05)。结论午间便携式睡眠监测加诊断性治疗对于嗜睡明显的OSAHS患者为一种临床上较为实用的诊断方法。

Objective To observe the diagnostic value of portable sleep monitoring and diagnostic treatment in patients with OSAHS. Methods From January 2015 to January 2018, patients with respiratory related diseases were admitted to the respiratory clinic of Shaoyang Central Hospital. The ESS score was ≥9 points, and there were no coronary heart disease, COPD, cerebrovascular disease, and 231 cases were received. Patients underwent portable sleep monitoring 1 hour before midday, CPAP diagnostic treatment 1 hour later, and PSG monitoring on the same day, comparing the sensitivity and specificity of the diagnosis of OSAHS in the midday portable sleep monitoring plus diagnostic treatment and simple midday portable sleep monitoring. Results After PSG monitoring, 186 of the 231 patients were diagnosed with obstructive sleep apnea hypopnea syndrome. The sensitivity of the midday portable sleep monitor was 78.0% and the specificity was 84.4%. The sensitivity of the diagnostic treatment was 93.5% and the specificity was 95.6%. The diagnostic sensitivity and specificity of the portable sleep monitor and diagnostic treatment in the afternoon were higher than those of the simple portable sleep breathing monitor, and the difference was statistically significant(P <0.05).Conclusion Midday portable sleep monitoring plus diagnostic treatment is a clinically useful diagnostic method for OSAHS patients with significant sleepiness.