便携式睡眠监测仪在儿童OSAHS诊断中的应用价值

Application value of portable sleep monitor in the diagnosis of OSAHS in children

目的探究便携式睡眠监测仪(PM)在儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)诊断中的应用价值。方法回顾性分析,选取2020年2月至2021年8月期间在茂名市妇幼保健院门诊就诊和住院的疑似OSAHS儿童80例[男42例、女38例,年龄(10.52±2.31)岁]为研究对象,以“鼻塞、睡时打鼾和张口呼吸”等为主诉症状。同步进行多导睡眠呼吸监测仪(PSG)与PM诊断。对比两种诊断方式中各指标(平均血氧饱和度、夜间血氧饱和度最低值、氧减指数)水平、OSAHS患儿检出率,分析PM的诊断效能(灵敏度、特异度及准确度)。采用配对t检验。结果PSG诊断平均血氧饱和度[(92.33±2.96)%]、夜间血氧饱和度最低值[(78.02±3.45)%]、氧减指数[(26.89±4.03)]与PM诊断方式比较[(93.72±3.18)%、(78.46±3.86)%、(26.51±4.21)],差异均无统计学意义(均P>0.05)。80例疑似OSAHS儿童中,经金标准PSG诊断检出正常10例、轻度28例、中度23例、重度19例;PM诊断检出正常9例、轻度26例、中度21例、重度18例。经金标准PSG诊断阳性70例,阴性10例;经PM诊断阳性65例,阴性9例,灵敏度为92.9%、特异度为90.0%、准确度为92.5%。结论儿童OSAHS经PM诊断的检出率较高,且该诊断方式的灵敏度、特异度及准确度均大于80%,具有较高的临床诊断价值。

Objective To investigate the application of portable sleep monitor in the diagnosis of obstructive sleep apnea-hypopnea syndrome(OSAHS)in children.Methods A retrospective study was performed on 80 children suspected with OSAHS who were hospitalized and treated in the outpatient department of Maoming Maternal and Child Health Hospital from February 2020 to August 2021,including 42 boys and 38 girls,aged(10.52±2.31)years.The main complaints were nasal congestion and snoring and mouth breathing during sleep.Simultaneous diagnosis with polysomnography(PSG)and portable sleep monitor was performed.The indexes(mean blood oxygen saturation,minimum blood oxygen saturation at night,and hypoxia index)and the detection rates of children with OSAHS of the two diagnostic methods were compared.The diagnostic efficiency(sensitivity,specificity,and accuracy)of portable sleep monitor was analyzed.Paired t test was used.Results There were no statistically significant differences in the mean blood oxygen saturation[(92.33±2.96)%vs.(93.72±3.18)%],minimum blood oxygen saturation at night[(78.02±3.45)%vs.(78.46±3.86)%],and hypoxia index[(26.89±4.03)vs.(26.51±4.21)]between PSG and portable sleep monitor.Among the 80 children suspected with OSAHS,10 cases were normal,28 cases were mild,23 cases were moderate,and 19 cases were severe diagnosed by gold standard PSG;PM diagnosis detected 9 normal cases,26 mild cases,21 moderate cases,and 18 severe cases.There were 70 positive cases and 10 negative cases diagnosed by gold standard PSG;there were 65 positive cases and 9 negative cases diagnosed by PM,and the sensitivity,specificity,and accuracy were 92.9%,90.0%,and 92.5%respectively.Conclusion The portable sleep monitor has a high detection rate in the diagnosis of OSAHS in children,and the sensitivity,specificity,and accuracy of this diagnostic method are more than 80%,which has a high clinical diagnostic value.