摘要
目的探讨夜间动态血氧饱和度（SaO2）监测对睡眠呼吸暂停综合征（SAS）患者的诊断价值。方法对比174例打鼾者的动态SaO2及多导生理仪睡眠呼吸监测结果，并根据睡眠呼吸暂停低通气指数（AHI）将其中的100例受试者分为非SAS组（AHI＜5）工例、轻度SAS（AHI5～19）26例、中度SAS（AHI20～39）25例、重度SAS（AHI≥40）23例四组，测定其持续气道正压通气（CPAP）治疗前后的动态SaO2变化。结果每小时氧饱和度下降≥4％的次数（DI4即氧减饱和度指数）与AHI的相关性好（r＝0．91，P＜0．001），能够较好地反映SAS患者睡眠呼吸紊乱的频度，对AHI≥5患者，DI4≥5的敏感性达94％以上，能够检出绝大多数的SAS患者；若以DI4≥15为标准，可以准确诊断98％以上的SAS患者，且两项指标都不会漏诊AHI≥20的患者。治疗前各组两两之间及治疗前后的DI4、氧饱和度≤90％的时间占总监测时间的百分比（SIT90）均有显著差异（P＜0．01）。结论选用适当的DI4作为标准，对初步筛选或准确判断SAS患者具有一定价值；DI4及SIT90能够较好地反映SAS患者夜间缺氧的程度，可作为综合判断SAS患者病情严重程度的指标，对SAS治疗效果的判定也有指导意义。
Objective Pulse oximeter is a useful screening device for SAS.We studied whether measurement of SaO2 could identify patients with SAS and evaluate the severity of SAS. Methods 174 snorers were assessed clinically and the underwent formal PSG and oximetry test at the same time. From the oximetry data, the percentage of time spent at SaO2 belew 90% (SIT90%), waking SaO2(H SaO2%), the lowest SaO2(L SaO2%)during sleep, the mean SaO2(M SaO2%) and the number of oxygen desaturation ≥4% per hour (DI4) were calculated. We also divided 100 cases among them into four gromp by AHI, which were G0(AHI < 5), G1 (AHI 5 ~19),G2(AHI 20 ~ 39), G3(AHI≥40), and evahaed whethr the SIT90, LSaO2, MSaO2 and DI4 are different among the four groups. Results There was an bostically significant correlation (r = 0.91 P < 0.001) between DI4 and AHI. DI4≥5 per hour identified patients with AHI > 5 with a sensitivity of 94%; DI4≥15 per hour identified patienis with AHI > 5 with a specificity of 98%, and for Patients with AHI≥20, the senstivity was 100%.The SIT90 and DI4 were significanily different among the four groups (P < 0.01). Conclusions Oximetry with DI4 < 5 practically excludes clinically significant SAS, and DI4≥15 identified the all of them. SIT90 and DI4could be used as parameters in evaluang the severity of SAS.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
1999年第6期332-334,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
