中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
1期
6-8
,共3页
汤日波%刘双%马长生%丁少芳%王丽%刘红艳%董建增%刘兴鹏%刘小慧%史力生%何华
湯日波%劉雙%馬長生%丁少芳%王麗%劉紅豔%董建增%劉興鵬%劉小慧%史力生%何華
탕일파%류쌍%마장생%정소방%왕려%류홍염%동건증%류흥붕%류소혜%사력생%하화
心房颤动%阻塞性睡眠呼吸暂停%颈围
心房顫動%阻塞性睡眠呼吸暫停%頸圍
심방전동%조새성수면호흡잠정%경위
Atrial fibrillation%Obstructive sleep apnea%Neck circumference
目的 探讨颈围、校正颈围筛查心房颤动(房颤)患者合并阻塞性睡眠呼吸暂停(OSA)的准确性.方法 入选行睡眠呼吸监测的房颤患者50例,测量颈围,计算校正颈围[校正颈围(cm)=实际颈围(cm)+4.0 cm(如果患者有高血压)+3.0 cm(如果患者有习惯性打鼾)+3.0 cm(如果患者夜间睡眠有憋气/窒息)].颈围、校正颈围与OSA严重程度行相关分析,通过受试者工作特征曲线评价颈围、校正颈围诊断OSA的正确性.以睡眠呼吸监测为金标准确定颈围、校正颈围诊断OSA的敏感性和特异性.结果 36例(72%)房颤患者有OSA,OSA组颈围显著大于非OSA组[(42.3±3.3)cm与(39.9±2.6)cm,t=2.411,P=0.020],OSA组校正颈围与非OSA组比较差异有统计学意义[(49.6±4.4)cm与(45.2±4.5)cm,t=3.168,P=0.003].颈围、校正颈围与OSA严重程度的相关系数分别为0.566、0.629(P均＜0.01).通过受试者工作特征曲线评价颈围、校正颈围对OSA初筛的评价作用,曲线下面积分别为0.729,0.746,曲线下面积差异无统计学意义(P=0.545).颈围以41.2 cm为界值,诊断OSA的敏感性为74.3%,特异性为71.4%.校正颈围以47.0 cm为界值,诊断OSA的敏感性为71.4%,特异性为71.4%.结论 颈围、校正颈围与OSA严重程度相关性良好,是房颤患者合并OSA初筛较可靠的指标.
目的 探討頸圍、校正頸圍篩查心房顫動(房顫)患者閤併阻塞性睡眠呼吸暫停(OSA)的準確性.方法 入選行睡眠呼吸鑑測的房顫患者50例,測量頸圍,計算校正頸圍[校正頸圍(cm)=實際頸圍(cm)+4.0 cm(如果患者有高血壓)+3.0 cm(如果患者有習慣性打鼾)+3.0 cm(如果患者夜間睡眠有憋氣/窒息)].頸圍、校正頸圍與OSA嚴重程度行相關分析,通過受試者工作特徵麯線評價頸圍、校正頸圍診斷OSA的正確性.以睡眠呼吸鑑測為金標準確定頸圍、校正頸圍診斷OSA的敏感性和特異性.結果 36例(72%)房顫患者有OSA,OSA組頸圍顯著大于非OSA組[(42.3±3.3)cm與(39.9±2.6)cm,t=2.411,P=0.020],OSA組校正頸圍與非OSA組比較差異有統計學意義[(49.6±4.4)cm與(45.2±4.5)cm,t=3.168,P=0.003].頸圍、校正頸圍與OSA嚴重程度的相關繫數分彆為0.566、0.629(P均＜0.01).通過受試者工作特徵麯線評價頸圍、校正頸圍對OSA初篩的評價作用,麯線下麵積分彆為0.729,0.746,麯線下麵積差異無統計學意義(P=0.545).頸圍以41.2 cm為界值,診斷OSA的敏感性為74.3%,特異性為71.4%.校正頸圍以47.0 cm為界值,診斷OSA的敏感性為71.4%,特異性為71.4%.結論 頸圍、校正頸圍與OSA嚴重程度相關性良好,是房顫患者閤併OSA初篩較可靠的指標.
목적 탐토경위、교정경위사사심방전동(방전)환자합병조새성수면호흡잠정(OSA)적준학성.방법 입선행수면호흡감측적방전환자50례,측량경위,계산교정경위[교정경위(cm)=실제경위(cm)+4.0 cm(여과환자유고혈압)+3.0 cm(여과환자유습관성타한)+3.0 cm(여과환자야간수면유별기/질식)].경위、교정경위여OSA엄중정도행상관분석,통과수시자공작특정곡선평개경위、교정경위진단OSA적정학성.이수면호흡감측위금표준학정경위、교정경위진단OSA적민감성화특이성.결과 36례(72%)방전환자유OSA,OSA조경위현저대우비OSA조[(42.3±3.3)cm여(39.9±2.6)cm,t=2.411,P=0.020],OSA조교정경위여비OSA조비교차이유통계학의의[(49.6±4.4)cm여(45.2±4.5)cm,t=3.168,P=0.003].경위、교정경위여OSA엄중정도적상관계수분별위0.566、0.629(P균＜0.01).통과수시자공작특정곡선평개경위、교정경위대OSA초사적평개작용,곡선하면적분별위0.729,0.746,곡선하면적차이무통계학의의(P=0.545).경위이41.2 cm위계치,진단OSA적민감성위74.3%,특이성위71.4%.교정경위이47.0 cm위계치,진단OSA적민감성위71.4%,특이성위71.4%.결론 경위、교정경위여OSA엄중정도상관성량호,시방전환자합병OSA초사교가고적지표.
Objective To investigate the screening value of neck circumference(NC)and adjusted neck circumference(ANC)for obstructive sleep apnea(OSA)in patients with atrial fibrillation(AF).Methods NC and ANC were measured in 50 patients with AF who underwent polysomnography.ANC=NC+4.0 cm(if hypertension exists)+3.0 am(if habitual snore exists)+3.0 cm(if choke or gasp exists at most night).Correlation analysis and receiver operating characteristic curve(ROC)were performed to evaluate the accuracy of NC and ANC for screening OSA.Results 36 patients had OSA by polysomnography.The NC and ANC were significantly higher in the OSA group than in the no-OSA group,with the mean value of 42.3±3.3 cm VS 39.9±2.6 cm (t=2.411,P=0.020)and 49.6±4.4 cm VS 45.2±4.5 cm(t=3.168,P=0.003),respectively.NC and ANC were correlated to the severity of OSA with the r valaes of 0.566(P＜0.01)and 0.629(P＜0.01),respectively.There was no significant difference between the area under the ROC of NC and ANC(0.729 VS 0.746,P=0.545).At a cutoff point of 41.2 cm and 47.0 cm,the sensitivity,specificity of NC for diagnosis of OSA were 74.3%,71.4% and 71.4%.71.4%respectively.Conclusion Both NC and ANC are simple and valid indices for screening OSA in patients with AF.
