[用于诊断睡眠呼吸暂停综合征的便携式三通道记录系统（Oxyflow，Edentec）的验证]

Jiménez Gómez A, Golpe Gómez R, Carpizo Alfayate R, de la Roza Fernández C, Fernández Rozas S, García Pérez M M

Unidad de Trastornos del Sueño, Hospital Universitario Marqués de Valdecilla, Santander.

Arch Bronconeumol. 2000 Jan;36(1):7-12. doi: 10.1016/s0300-2896(15)30226-x.

OBJECTIVE

To evaluate the usefulness of a portable recording device (Oxyflow, EdenTec) to measure oronasal airflow, oxygen saturation and arterial pulse for diagnosing sleep apnea syndrome (SAS) using conventional polysomnography as the gold standard.

METHODS

Sixty-two subjects suspected of having SAS were studied prospectively by simultaneously recording conventional polysomnography and Oxyflow data in the sleep laboratory. Two different investigators, blinded to each other's findings, interpreted the data from each method. The apnea-hypopnea index (AHI) cut-off points used were?? 10, 15 and 30. The sensitivity, specificity, positive predictive value and negative predictive value of the Oxyflow indices for each AHI cut-off point were calculated. Both computer-generated and manually collected data from the Oxyflow device were analyzed. Manual readings were recorded by two independent investigators and interobserver agreement was calculated. The usefulness of both automatic and manual analyses for SAS diagnosis was assessed using receiver operating characteristic curves (ROC).

RESULTS

Fifty-eight (93.5%) men and 4 (6.5%) women with a mean age (+/- SD) of 53 +/- 11 years (29-73) were enrolled. An AHI > or = 10 was observed in 58% of the patients and mean AHI was 25 +/- 28 (0-125). The index of respiratory disturbance per hour of analysis with desaturation events > or = 4% (RDI4%) was the parameter with the largest area under the ROC curve (0.90 for AHI > or = 10; 0.94 for AHI > or = 15 and 0.96 for AHI > or 30). Manual reading was practical and reproducible (agreement 0.93, kappa coefficient 0.82) but its efficiency was no greater than that of automatic analysis.

CONCLUSIONS

The Oxyflow device may be a useful diagnostic tool for SAS. Its portability and simplicity makes it potentially useful for in-home studies.

目的

以传统多导睡眠图作为金标准，评估一种便携式记录设备（Oxyflow，EdenTec）用于测量口鼻气流、血氧饱和度和动脉脉搏以诊断睡眠呼吸暂停综合征（SAS）的有效性。

方法

对62名疑似患有SAS的受试者进行前瞻性研究，在睡眠实验室同时记录传统多导睡眠图和Oxyflow数据。两名互不了解对方结果的不同研究者对每种方法的数据进行解读。使用的呼吸暂停低通气指数（AHI）截断点为≥10、≥15和≥30。计算每个AHI截断点的Oxyflow指数的敏感性、特异性、阳性预测值和阴性预测值。对Oxyflow设备的计算机生成数据和手动收集数据均进行分析。由两名独立研究者记录手动读数，并计算观察者间一致性。使用受试者工作特征曲线（ROC）评估自动和手动分析对SAS诊断的有效性。

结果

纳入58名（93.5%）男性和4名（6.5%）女性，平均年龄（±标准差）为53±11岁（29 - 73岁）。58%的患者AHI≥10，平均AHI为25±28（0 - 125）。每小时分析中伴有≥4%去饱和事件的呼吸紊乱指数（RDI4%）是ROC曲线下面积最大的参数（AHI≥10时为0.90；AHI≥15时为0.94；AHI≥30时为0.96）。手动读数实用且可重复（一致性为0.93，kappa系数为0.82），但其效率不高于自动分析。