摘要
目的探讨利用Ⅲ型便携式睡眠监测仪进行家庭睡眠呼吸暂停监测(HSAT)对慢性阻塞性肺疾病(慢阻肺)患者合并的阻塞性睡眠呼吸暂停(OSA)的诊断价值。方法收集2015年9月至2018年11月就诊于北京大学国际医院睡眠中心,疑诊OSA的慢阻肺患者共75例,依次进行经Ⅲ型便携式睡眠监测仪的HSAT和在睡眠实验室进行同步多导睡眠图(PSG)监测及便携式睡眠监测仪监测(PMT)。计算患者自行佩戴便携式睡眠监测仪行HSAT的成功率,评价两种方法得出的呼吸暂停低通气指数(AHI)与PSG的一致性,以及诊断慢阻肺患者中OSA的灵敏度和特异度。结果HSAT实施的成功率为88%(66/75),HSAT及PMT的AHI[M(Q1,Q3)]分别为16.25(9.23,30.68)、17.95(8.63,40.50)次/h,与相应的PSG的AHI[18.25(7.48,44.65)次/h]相关(r值分别为0.898、0.966,均P<0.001)。Bland-Altman分析显示,HSAT及PMT和PSG所得AHI均有较高的一致性。以AHI≥30次/h为诊断标准,HSAT和PMT诊断OSA的特异度均超过95%。结论无论在家庭还是在实验室,应用Ⅲ型便携式睡眠监测仪用于慢阻肺患者中OSA的诊断均有较大价值。
Objective To evaluate the utility of a typeⅢportable monitor to diagnose obstructive sleep apnea(OSA)in adults with chronic obstructive pulmonary disease(COPD).Methods A total of 75 COPD patients with suspected OSA,who visited the Peking University International Hospital from September 2015 to November 2018,were recruited and performed home sleep apnea testing(HSAT)using typeⅢportable monitor at home followed by an polysomnography(PSG)and the same portable monitor test(PMT)in sleep laboratory.The success rates of HSAT by portable monitor were calculated;the agreement of apnea and hypopnea index(AHI)between HSAT and PSG as well as the PMT and PSG was analyzed by Bland-Altman plot,the sensitivity and specificity of portable monitor in the diagnosis of OSA in COPD patients were evaluated.Results The success rates of HSAT was 88%(66/75).AHI[M(Q1,Q3)]was 16.25(9.23,30.68)and 17.95(8.63,40.50)events/h on HSAT and PMT,respectively,both had no significant difference with AHI on PSG[18.25(7.48,44.65)events/h].Bland-Altman analysis indicated that AHI on HSAT and PMT had high agreement with AHI derived from PSG(r=0.898,0.966,both P<0.001).Using an AHI≥30 events/h to diagnose OSA,typeⅢportable monitor both at home and in sleep lab had diagnostic specificity over 95%.Conclusion TypeⅢportable monitor can be used either at home or in sleep lab to diagnose OSA in COPD patients.
作者
张伟
陈燕文
高莹卉
董霄松
左玉花
余永波
冯军军
常远
韩芳
Zhang Wei;Chen Yanwen;Gao Yinghui;Dong Xiaosong;Zuo Yuhua;Yu Yongbo;Feng Junjun;Chang Yuan;Han Fang(Department of PKU-UPenn Sleep Center,Peking University International Hospital,Beijing 102206,China;Department of Respiratory and Critical Care Medicine,Peking University People′s Hospital,Beijing 100044,China;Department of Respiratory and Critical Care Medicine,Peking University International Hospital,Beijing 102206,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2020年第28期2186-2191,共6页
National Medical Journal of China
