[脉搏血氧饱和度筛查用于卒中患者睡眠呼吸障碍]

[Pulse oximetry screening for sleep-disordered breathing in stroke].

作者信息

Wessendorf T E, Alymov G, Wang Y M, Stampa J, Thilmann A F, Teschler H

机构信息

Ruhrlandklinik, Abt. Pneumologie/Schlaf- und Beatmungsmedizin, Essen, Germany.

出版信息

Pneumologie. 2002 Jun;56(6):357-62. doi: 10.1055/s-2002-32170.

DOI:10.1055/s-2002-32170

PMID:12063616

Abstract

BACKGROUND

The prevalence of sleep-disordered breathing, particularly obstructive sleep apnea, among stroke patients is high. Routine screening with the current diagnostic gold standard of polysomnography is not feasible. Pulse oximetry could be a simple screening test.

METHODS

The signal of pulse oximetry, recorded during full polysomnography in 184 stroke patients during neurological rehabilitation, was analyzed automatically by software for desaturations >/= 4 %. The polysomnographic apnoea-hypopnoea-index (AHI) was used as the diagnostic gold standard and compared with the oxygen desaturation index (ODI).

RESULTS

Correlation between AHI of PSG and ODI of oximetry was r = 0.84 (p < 0.001). Dependent on the definition of SDB (AHI 10, 15, 20 or 30/h) and the cut-off-point for the ODI (e. g. 15/h) sensitivity was 32 - 83 % and specificity 99 - 96 %. The diagnostic accuracy as determined by the area under the ROC-curve was 96 %.

CONCLUSION

Automated analysis of pulse oximetry gives reasonable results for screening for SDB in stroke patients and could be used in populations with high pre-test probability.

摘要

背景

睡眠呼吸障碍，尤其是阻塞性睡眠呼吸暂停，在中风患者中的患病率很高。采用当前诊断金标准多导睡眠图进行常规筛查并不可行。脉搏血氧饱和度测定法可能是一种简单的筛查测试。

方法

对184例中风患者在神经康复期间进行全夜多导睡眠图检查时记录的脉搏血氧饱和度信号，通过软件自动分析饱和度下降≥4%的情况。多导睡眠图呼吸暂停低通气指数（AHI）用作诊断金标准，并与氧饱和度下降指数（ODI）进行比较。

结果

多导睡眠图的AHI与脉搏血氧饱和度测定法的ODI之间的相关性为r = 0.84（p < 0.001）。根据睡眠呼吸障碍的定义（AHI为10、15、20或30次/小时）以及ODI的截断点（例如15次/小时），敏感性为32% - 83%，特异性为99% - 96%。由ROC曲线下面积确定的诊断准确性为96%。