摘要
目的 评价基于外周动脉血管张力参数原理（peripheral arterial tone,PAT）的腕式睡眠监测仪Watch-PAT 200对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的诊断价值.方法 分别用Watch-PAT 200和多道睡眠监测图（PSG）对43例打鼾患者行整夜7h睡眠同步监测.由2名专业的分析人员采用双盲法分别对PSG结果进行人工分析；Watch-PAT睡眠监测结果由仪器自动分析.比较两种方法诊断OSAHS的一致性.结果 43例受试者平均（（x）±s,以下同）年龄（42.2±12.2）岁,体质量指数（28.0±3.9） kg/m2.受试者PSG测得平均呼吸暂停低通气指数（AHI）为（34.9±29.9）次/h,PAT测得AHI为（36.0±29.2）次/h.对所有受试者PSG和PAT测得的AHI、最低血氧饱和度进行相关分析,相关系数分别为0.931和0.926,P值均＜0.01.采用Bland-Altman法对两种检测方法进行一致性评价,95.3％的数据在95％一致性界限之内.以AHI≥5次/h为诊断OSAHS阳性标准,两种方法一致性检验Kappa=0.688,P=0.000,有统计学意义；Watch-PAT检测的灵敏度为94.7％,特异度为80.0％,误诊率为20.0％,漏诊率为5.3％,诊断符合率为93.0％.采用ROC曲线方法,分别以PSG测得AHI大于等于5或30次/h为阈值,Watch-PAT检测的灵敏度和特异度分别为82.6％和100.0％,以及95.0％和95.7％.结论 Watch-PAT 200可作为一种便捷工具诊断OSAHS.
Objective To assess the accuracy of a wrist-worn device （Watch-PAT 200） in the diagnosis of obstructive sleep apnea syndrome （OSAHS）. Methods Forty-three adult subjects with suspected OSAHS simultaneously had a standard in-laboratory polysomnogram （PSG） and wore the WatchPAT 200 during a full-night recording.PSG sleep and respiratory events were scored according to standard criteria. The PSG recordings were blindly manually analyzed, while Watch-PAT data were scored automatically based on the algorithm developed previously.Results The mean age of the subjects was （42.2 ± 12.2） years （（x） ±s）,and mean body mass index was （28.0 ±3.9） kg/m2.Mean PSG apnea hypopnea index （AHI） was （34.9 ± 29.9） events per hour,and mean PAT-AHI was （36.0 ± 29.2） events per hour.There was a significant correlation between PAT AHI and AHI by PSG （r =0.931,P 〈0.01 ）.A Bland-Altman plot of PAT AHI and PSG AHI was also used to assess the accuracy of Watch-PAT 200.At lower levels of AHI,PAT tended to overestimate disease severity,while at higher levels of AHI,Watch-PAT underestimated severity.To assess sensitivity and specificity of Watch-PAT,constructed receiver operator characteristic curves using a variety of AHI threshold values （5,15 and 30 events per hour）.For AHI ≥5events per hour as threshold value,the Watch-PAT diagnosing rate was 93%,and sensitivity as well as specificity were 94.7% and 80.0%.The misdiagnosis rate and missed diagnosis rate were 20.0% and 5.3%.Optimal combinations of sensitivity and specificity for the AHI threshold values （ 15 and 30 events per hour） were 82.6% and 100.0%,95.0% and 95.7% respectively.Conclusion The Watch-PAT 200 may offer an accurate,robust,and reliable ambulatory method for the detection of OSAHS,with minimal patient discomfort.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2012年第2期112-116,共5页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
