CAJ | 학술논문

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.
목적 평개기우외주동맥혈관장력삼수원리(peripheral arterial tone,PAT)적완식수면감측의Watch-PAT 200대조새성수면호흡잠정저통기종합정(OSAHS)적진단개치.방법 분별용Watch-PAT 200화다도수면감측도(PSG)대43례타한환자행정야7h수면동보감측.유2명전업적분석인원채용쌍맹법분별대PSG결과진행인공분석；Watch-PAT수면감측결과유의기자동분석.비교량충방법진단OSAHS적일치성.결과 43례수시자평균((x)±s,이하동)년령(42.2±12.2)세,체질량지수(28.0±3.9) kg/m2.수시자PSG측득평균호흡잠정저통기지수(AHI)위(34.9±29.9)차/h,PAT측득AHI위(36.0±29.2)차/h.대소유수시자PSG화PAT측득적AHI、최저혈양포화도진행상관분석,상관계수분별위0.931화0.926,P치균＜0.01.채용Bland-Altman법대량충검측방법진행일치성평개,95.3％적수거재95％일치성계한지내.이AHI≥5차/h위진단OSAHS양성표준,량충방법일치성검험Kappa=0.688,P=0.000,유통계학의의；Watch-PAT검측적령민도위94.7％,특이도위80.0％,오진솔위20.0％,루진솔위5.3％,진단부합솔위93.0％.채용ROC곡선방법,분별이PSG측득AHI대우등우5혹30차/h위역치,Watch-PAT검측적령민도화특이도분별위82.6％화100.0％,이급95.0％화95.7％.결론 Watch-PAT 200가작위일충편첩공구진단OSAHS.
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.