Masa J F, Corral J, Teran J, Martin M J, Disdier C, Rubio M, Mota M, Zamorano J, Montserrat J M
Pulmonary Service, San Pedro de Alcántara Hospital, Cáceres, Spain.
Eur Respir J. 2009 Jul;34(1):156-61. doi: 10.1183/09031936.00160208. Epub 2009 Feb 12.
Obstructive nonapnoeic event (ONE) scoring is shrouded in confusion. This is important in patients with mild disease, in whom precision is crucial. The aims of the present study were: 1) to identify ONEs using oesophageal pressure (OP) (OP-ONEs) and a noninvasive (NI) method (NI-ONEs); 2) to compare both methods of scoring; and 3) to determine the contribution of ONE definitions to clinical findings. Patients with suspected sleep apnoeas (respiratory disturbance index <or=10) during a first polysomnography were subjected to a second with an OP measurement. OP-ONEs and NI-ONEs were defined as an increase in OP or discernible reduction in the amplitude of thoracoabdominal bands with both desaturation and/or arousal. Bland-Altman analysis established agreement. Comparisons were made between OP-ONEs, NI-ONEs and clinical findings. In our sample (n = 90), the addition of an arousal to the NI-ONEs or OP-ONEs with only desaturation increased the number of NI-ONEs by 329 and 362%, respectively. NI-ONEs with arousal and/or desaturation detected 91% of OP-ONEs. The association with sleepiness depended on the incorporation of arousal into the definition of ONEs. In patients with mild disease, the addition of an arousal to ONEs, with only desaturation, markedly increased respiratory disturbance index, with probable therapeutic implications. Scoring respiratory events as apnoea and ONEs is easier and sufficiently accurate.
阻塞性无呼吸事件（ONE）评分存在诸多混淆之处。这对于轻度疾病患者尤为重要，因为在这类患者中精确性至关重要。本研究的目的是：1）使用食管压力（OP）（OP-ONEs）和一种非侵入性（NI）方法（NI-ONEs）识别ONE；2）比较两种评分方法；3）确定ONE定义对临床发现的贡献。在首次多导睡眠监测期间疑似睡眠呼吸暂停（呼吸紊乱指数≤10）的患者，在第二次监测时进行OP测量。OP-ONEs和NI-ONEs被定义为OP升高或胸腹带幅度明显降低，同时伴有去饱和和/或觉醒。Bland-Altman分析确定了一致性。对OP-ONEs、NI-ONEs和临床发现进行了比较。在我们的样本（n = 90）中，仅将觉醒添加到仅伴有去饱和的NI-ONEs或OP-ONEs中，分别使NI-ONEs的数量增加了329%和362%。伴有觉醒和/或去饱和的NI-ONEs检测到91%的OP-ONEs。与嗜睡的关联取决于将觉醒纳入ONE的定义中。在轻度疾病患者中，仅将觉醒添加到仅伴有去饱和的ONE中，会显著增加呼吸紊乱指数，可能具有治疗意义。将呼吸事件评为呼吸暂停和ONE更容易且足够准确。
