Patil Susheel P, Punjabi Naresh M, Schneider Hartmut, O'Donnell Christopher P, Smith Philip L, Schwartz Alan R
Johns Hopkins Sleep Disorders Center, Asthma and Allergy Building, 5501 Hopkins Bayview Circle, Room 4B.50, Baltimore, MD 21224, USA.
Am J Respir Crit Care Med. 2004 Jul 1;170(1):86-93. doi: 10.1164/rccm.200309-1239OC. Epub 2004 Apr 7.
Upper airway critical pressure measurements correlate with the degree of upper airway obstruction during sleep and may have a role in the diagnosis and treatment of obstructive sleep apnea. Nevertheless, the utility of the critical pressure has not yet been realized in the clinical setting because significant technical expertise is still required for the acquisition and analysis of pressure-flow data. Using segmented regression, we developed and validated a simplified approach to analyze the pressure-flow relationship and to determine the effects of protocol-related factors in 44 subjects with sleep apnea. When compared with expert visual analysis, segmented regression method was found to accurately determine the critical pressure (-0.98 +/- 2.47 cm H(2)O vs. -1.07 +/- 2.47 cm H(2)O, respectively; p = 0.46). Furthermore, it was found that two series of measurements acquired at varying nasal pressure levels with two or more breaths per level were sufficient to determine the critical pressure with a minimum of variability. Therefore, this analytic approach has the potential for standardizing and simplifying the ascertainment of the critical pressure for studies examining the effect of therapeutic devices and agents on upper airway collapsibility during sleep.
上气道临界压力测量值与睡眠期间上气道阻塞程度相关，可能在阻塞性睡眠呼吸暂停的诊断和治疗中发挥作用。然而，临界压力在临床环境中的实用性尚未得到实现，因为获取和分析压力-流量数据仍需要大量技术专长。我们使用分段回归法，开发并验证了一种简化方法，用于分析44例睡眠呼吸暂停患者的压力-流量关系，并确定方案相关因素的影响。与专家视觉分析相比，分段回归法被发现能准确确定临界压力（分别为-0.98±2.47 cm H₂O和-1.07±2.47 cm H₂O；p = 0.46）。此外，研究发现，在不同鼻压水平下进行的两组测量，每组测量有两次或更多次呼吸，足以以最小的变异性确定临界压力。因此，这种分析方法有可能使研究治疗装置和药物对睡眠期间上气道可塌陷性影响的临界压力测定标准化和简化。
