CAJ | 학술논문

目的评价脉搏传导时间(pulse transit time,PTT)在判断呼吸暂停性质方面的准确性,为临床应用该方法提供依据.方法 32例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者被纳入本研究.多道睡眠监测(PSG)共监测得到10 305次呼吸暂停事件.应用PTT和食管压分别分析所有呼吸暂停事件,综合比较两次分析结果 ,探讨PTT的准确性.比较动眼和非动眼睡眠期的PTT准确性,并分析每个患者PTT准确性与临床资料的关系.结果在判断呼吸暂停性质方面,PTT与食管压的总体一致率达到96.7%(9970/10305).以食管压的判断为金标准,PTT检出中枢性、阻塞性和混合性呼吸暂停的敏感度分别为88.0%、91.3%和97.8%;特异度分别为99.8%、97.8%和92.8%.暂停事件的错判主要集中于阻塞性和混合性呼吸事件间相互错判.动眼和非动眼睡眠期PTT判断的准确性差异无统计学意义.PTT判断呼吸事件的准确率与年龄、BMI、最低血氧饱和度、AHI等无明显相关性.结论 PTT与食管压在判断呼吸事件性质方面有很好的一致性,对各类呼吸暂停的检出都具有很高的敏感度和特异度,是无创检出呼吸驱动力的良好方法 .
목적 평개맥박전도시간(pulse transit time,PTT)재판단호흡잠정성질방면적준학성,위림상응용해방법 제공의거.방법 32례조새성수면호흡잠정저통기종합정(OSAHS)환자피납입본연구.다도수면감측(PSG)공감측득도10 305차호흡잠정사건.응용PTT화식관압분별분석소유호흡잠정사건,종합비교량차분석결과 ,탐토PTT적준학성.비교동안화비동안수면기적PTT준학성,병분석매개환자PTT준학성여림상자료적관계.결과 재판단호흡잠정성질방면,PTT여식관압적총체일치솔체도96.7%(9970/10305).이식관압적판단위금표준,PTT검출중추성、조새성화혼합성호흡잠정적민감도분별위88.0%、91.3%화97.8%;특이도분별위99.8%、97.8%화92.8%.잠정사건적착판주요집중우조새성화혼합성호흡사건간상호착판.동안화비동안수면기PTT판단적준학성차이무통계학의의.PTT판단호흡사건적준학솔여년령、BMI、최저혈양포화도、AHI등무명현상관성.결론 PTT여식관압재판단호흡사건성질방면유흔호적일치성,대각류호흡잠정적검출도구유흔고적민감도화특이도,시무창검출호흡구동력적량호방법 .
Objective To assess the accuracy of pulse transit time (PTT) in classification of apnea events, and collect data for clinical application reference. Methods Thirty-two obstructive sleep apnea-hypopnea syndrome (OSAHS) patients included in the research had Polysomnography (PSG), and 10 305 apnea events were recorded. All the events were analyzed by PTT and esophageal pressure (Pes) respectively. The results were analyzed to assess the accuracy of PTT and compare the accuracy of pulse transit time between REM stage and NREM stage, and analyze the correlation between age, body mass index (BMI), apnea hypopnea index (AHI) and concordance rate in every patient. Results The total concordance rate between PTT and Pes in classification of apnea was 96. 7% (9970/10305). The sensitivities of PTT in detecting central, mixed and obstructive apnea were 88.0%, 91.3% and 97.8% respectively and the specificities were 99.8% ,97.8% and 92.8% respectively. The false determinations of apnea events mainly concentrated on the false determinations between the obstructive and mixed apnea. There was no statistical significant between the accuracy of PTT in different sleep stages. There was a negative relationship between the age, BMI, Lowest SaO2 AHI and the concordance rate. Conclusions There was good concordance between PTT and Pes in classification of apnea. PTT had very high sensitivity and specificity in detecting all kinds of apnea. This study showed that PTT can detect respiratory drive noninvasively with high accuracy.