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单通道便携监测仪在阻塞性睡眠呼吸暂停诊断中的评价。

Evaluation of a single-channel portable monitor for the diagnosis of obstructive sleep apnea.

机构信息

UPMC Sleep Medicine Center, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA

出版信息

J Clin Sleep Med. 2011 Aug 15;7(4):384-90. doi: 10.5664/JCSM.1196.

Abstract

STUDY OBJECTIVE

To validate the ApneaLINK (AL) as an accurate tool for determining the presence of obstructive sleep apnea (OSA) in an at-risk sleep clinic population in a home test environment.

METHODS

Consecutive participants referred with the suspicion of OSA were evaluated in the home with the AL portable monitor (AL Home), followed by simultaneous data collection with diagnostic polysomnography (PSG) and AL in the sleep laboratory (AL Lab). Prevalence, sensitivity, specificity, and ROC curves were calculated for PSG vs. AL Lab, PSG vs. AL Home, and AL Lab vs. AL Home test. Pearson correlations and Bland-Altman plots were constructed.

RESULTS

Fifty-three (55% female) participants completed the entire study. The mean age of the population was 45.1 ± 11.3 years, and body mass index was 35.9 ± 9.1 kg/m(2). The prevalence of an apnea hypopnea index (AHI) ≥ 15 in the cohort was 35.9%. The results demonstrated a high sensitivity and specificity of the AL respiratory disturbance index (RDI-AL) compared with the AHI from the PSG. The AL Lab had the highest sensitivity and specificity at RDI-AL values ≥ 20 events/h (sensitivity 100%, specificity 92.5%). The AL Home was most sensitive and specific at an RDI-AL ≥ 20 events/h (sensitivity 76.9%, specificity 92.5%). The Pearson correlations for PSG vs. AL Lab and PSG vs. AL Home were ρ = 0.88 and ρ = 0.82, respectively. The Bland-Altman Plots demonstrated good agreement between the methodologies.

CONCLUSION

The AL home test is an accurate alternative to PSG in sleep clinic populations at risk for moderate and severe OSA.

TRIAL REGISTRATION

clinicaltrials.gov ID: NCT00354614.

摘要

研究目的

验证 ApneaLINK(AL)作为一种在家庭测试环境中确定有风险的睡眠诊所人群中阻塞性睡眠呼吸暂停(OSA)存在的准确工具的准确性。

方法

连续有 OSA 怀疑的参与者在家庭中使用 AL 便携式监测仪(AL Home)进行评估,随后在睡眠实验室中同时进行与诊断性多导睡眠图(PSG)和 AL 的数据收集(AL Lab)。计算 PSG 与 AL Lab、PSG 与 AL Home 和 AL Lab 与 AL Home 测试之间的患病率、敏感性、特异性和 ROC 曲线。构建 Pearson 相关性和 Bland-Altman 图。

结果

53 名(55%为女性)参与者完成了整个研究。人群的平均年龄为 45.1 ± 11.3 岁,体重指数为 35.9 ± 9.1 kg/m²。该队列中呼吸暂停低通气指数(AHI)≥15 的患病率为 35.9%。结果表明,与 PSG 的 AHI 相比,AL 呼吸干扰指数(RDI-AL)具有较高的敏感性和特异性。当 RDI-AL 值≥20 事件/h 时,AL Lab 具有最高的敏感性和特异性(敏感性 100%,特异性 92.5%)。当 RDI-AL≥20 事件/h 时,AL Home 最敏感和特异(敏感性 76.9%,特异性 92.5%)。PSG 与 AL Lab 和 PSG 与 AL Home 的 Pearson 相关性分别为 ρ=0.88 和 ρ=0.82。Bland-Altman 图表明两种方法之间具有良好的一致性。

结论

在有中重度 OSA 风险的睡眠诊所人群中,AL 家庭测试是 PSG 的一种准确替代方法。

试验注册

clinicaltrials.gov ID:NCT00354614。

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