右美托咪定滴定判断不宁腿综合征的准确性

Accuracy of dexmedetomidine titration in diagnosis of restless legs syndrome

收集2019年2月至2021年1月,采用右美托咪定行以病人自控睡眠为主线的多模式睡眠疗法的睡眠障碍病人的病历资料,年龄≥18岁,BMI 18~30 kg/m^(2),性别不限。采用微量注射泵以60 ml/h(4μg/ml)的速率静脉输注右美托咪定,进入非快速眼动(NREM)Ⅲ期睡眠或达到1μg/kg后停止输注。参照《中国不宁腿综合征的诊断与治疗指南(2021版)》的诊断标准,判断右美托咪定是否诱发了不宁腿综合征(RLS)。滴定结束待病人清醒后次日,按照《中国不宁腿综合征的诊断与治疗指南(2021版)》的诊断标准进行临床诊断确定是否合并RLS。采用Kappa一致性检验评估右美托咪定滴定和《中国不宁腿综合征的诊断与治疗指南(2021版)》的诊断标准判断RLS的一致性。计算右美托咪定滴定判断RLS的灵敏度和特异度。共纳入39例病人,经右美托咪定滴定判断8例病人出现RLS症状。Kappa一致性检验结果表明,右美托咪定滴定和《中国不宁腿综合征的诊断与治疗指南(2021版)》的诊断标准判断RLS具有较强的一致性(Kappa值1.0,P<0.01)。右美托咪定滴定法判断RLS的灵敏度为100%,特异度为100%。综上所述,右美托咪定滴定可准确地判断RLS。

The medical records of patients of both sexes with sleep disorders treated with multimodal sleep therapy for which patient controlled sleep with dexmedetomidine was the main method,aged≥18 yr,with body mass index of 18-30 kg/m^(2),from February 2019 to January 2021,were collected.Dexmedetomidine 60 ml/h(4μg/ml)was intravenously infused until non-rapid eye movement(NREM)Ⅲphase was reached or the consumption of dexmedetomidine reached 1μg/kg.Whether dexmedetomidine induced restless legs syndrome(RLS)was judged according to the Chinese guidelines for the diagnosis and treatment of restless legs syndrome(2021 edition).When the titration was stopped and on the next day after emergence from anesthesia,clinical diagnosis was performed according to Chinese guidelines for the diagnosis and treatment of restless legs syndrome(2021 edition)to determine whether RLS was combined or not.Kappa consistency analysis was used to assess the consistency between dexmedetomidine titration and the Chinese guidelines for the diagnosis and treatment of restless legs syndrome(2021 Edition)in diagnosis of RLS.The sensitivity and specificity of diagnosis of RLS by dexmedetomidine titration were calculated.A total of 39 patients were included and 8 patients had RLS symptoms which were judged accroding to dexmedetomidine titration.The results of Kappa consistency test showed that there was a strong consistency between dexmedetomidine titration and Chinese guidelines for the diagnosis and treatment of restless legs syndrome(2021 edition)(Kappa value 1.0,P<0.01).The sensitivity and specificity of dexmedetomidine titration in judging RLS were 100%.In conclusion,dexmedetomidine titration can accurately judge RLS.