Verse T, Pirsig W, Junge-Hülsing B, Kroker B
Sektion für Rhinologie und Rhonchopathien, Universitäts-HNO-Klinik Ulm.
HNO. 1999 Apr;47(4):256-61.
For some time, the ambulatory diagnosis of respiratory disturbances during sleep has included the use of seven-channel recording units. One of these systems is the POLY-MESAM unit (MAP, Germany).
The aim of the present study was to validate the POLY-MESAM system by simultaneously performing 12-channel polysomnography. Forty-nine patients (45 males and 4 females) with different severities of obstructive sleep-related breathing disorders were included. Obstructive sleep apnea was diagnosed, when an apnea-hypopnea index (AHI) > 15 was found by polysomnography. The sensitivity and specificity for POLY-MESAM were calculated on the basis of the polysomnographic AHI.
The sensitivity of POLY-MESAM for detecting patients with an AHI > 15 was 86.4% and the specificity was 100%.
The POLY-MESAM system was easy to use. The sensitivity and specificity for the MESAM4 unit were 92% and 97% respectively, which was similar to POLY-MESAM. Additionally, POLY-MESAM provided the possibility for distinguishing the different kinds of apneas. Thus, POLY-MESAM was considered to be a useful development of the previous MESAM4 unit. In some cases, use of the POLY-MESAM unit resulted in underestimation of the AHI. POLY-MESAM produced false-negative results in patients with mild to moderate OSA. This finding was reflected in the relatively poorer sensitivity of the method (86.4%). Cardiorespiratory sleep studies (as possible with POLY-MESAM) are best limited to patients for whom the diagnosis of OSA is highly probable or as a follow-up tool in selected circumstances.
一段时间以来,睡眠期间呼吸障碍的门诊诊断一直包括使用七通道记录装置。其中一个系统是POLY-MESAM装置(德国MAP公司)。
本研究的目的是通过同时进行12通道多导睡眠图来验证POLY-MESAM系统。纳入了49例患有不同严重程度阻塞性睡眠相关呼吸障碍的患者(45例男性和4例女性)。当多导睡眠图发现呼吸暂停低通气指数(AHI)>15时,诊断为阻塞性睡眠呼吸暂停。基于多导睡眠图的AHI计算POLY-MESAM的敏感性和特异性。
POLY-MESAM检测AHI>15患者的敏感性为86.4%,特异性为100%。
POLY-MESAM系统易于使用。MESAM4装置的敏感性和特异性分别为92%和97%,与POLY-MESAM相似。此外,POLY-MESAM提供了区分不同类型呼吸暂停的可能性。因此,POLY-MESAM被认为是先前MESAM4装置的有益发展。在某些情况下,使用POLY-MESAM装置会导致AHI被低估。POLY-MESAM在轻度至中度阻塞性睡眠呼吸暂停患者中产生假阴性结果。这一发现反映在该方法相对较差的敏感性(86.4%)上。心肺睡眠研究(如使用POLY-MESAM可能进行的那样)最好仅限于阻塞性睡眠呼吸暂停诊断可能性很高的患者,或在特定情况下作为随访工具。